
Book— 
Copyright^? 



J O* 









COPYRIGHT DEPOSfP. 




fy 0- 



INTESTINAL 
IRRIGATION 



OR 



WHY, HOW, AND WHEN TO 
FLUSH THE COLON 



TREATED IN CONNECTION WITH OTHER MATTERS 
OF PHYSIOLOGICAL INTEREST AND 
, IMPORTANCE 



ALCINOUS B. JAMISON, M.D. 

AUTHOR OF " INTESTINAL ILLS," " HOW TO BECOME 
STRONG," ETC. 



Published by the Author 



Third Edition 

NEW YORK CITY 

43 West Forty-fifth Street 

1914 






Copyright, 1914 

BY 

ALCINOUS B. JAMISON 



NOV -9 1914 
A*. 

38 



C!.A38771« 



Even from the Body's Purity, the Mind 
Receives a secret sympathetic aid." 

— Thomson. 



PREFACE. 

WITHIN the last three decades the diagnosis 
and treatment of bowel troubles have been 
greatly changed through improved instruments, 
technique, hygienic measures, and various remedial 
agents. 

The domain of surgery of the anus, rectum, etc., 
has been surprisingly limited, and that of gastro- 
intestinal hygiene enlarged, together with knowl- 
edge of man's assimilative and eliminative organs. 
Systemic and local hygiene has supplanted drugs 
and surgery in the treatment of diseases of the 
anus, rectum, sigmoid flexure, and vermiform ap- 
pendix. Indeed, the domain of surgery will be 
restricted to what are still considered incurable 
diseases if the suggestions of this volume are 
widely adopted. From a clinical experience ex- 
tending over a period of thirty-three years, how- 
ever, — as a specialist in diseases of the anus, 
rectum, and intestinal machinery generally, — the 
author feels warranted in maintaining that, if hy- 
gio-therapic measures were taken by both physi- 
cians and laymen, surgical clinics and hospitals 



Preface 

for "operating" on anal and rectal diseases and 
the administering of countless medicinal reme- 
dies would enter the stage of therapeutic oblivion. 

The present work is more comprehensive in its 
scope than its title, Intestinal Irrigation, would 
at first thought seem to indicate. It is a practical 
book on home relief for all the symptoms of that 
form of internal inflammation known as proctitis 
and colitis. The measures that may safely be 
taken by the victim himself, without consulting a 
physician, are minutely explained ; and, that he 
may understand his own case, every chapter goes 
more or less extensively into anatomical, physio- 
logical, and pathological details. 

The author has kept abreast of the advancement 
of science in relation to his special branch of the 
healing art, and as the outcome of his large daily 
experience in this line he feels qualified to speak 
with authority. Victims of any of the symptoms 
described in this book may therefore have confi- 
dence in its statements. It conveys a message of 
common sense to the world at large and to the vic- 
tims of intestinal ills in particular. It is a compi- 
lation of clinical talks to the authors patients, 
making plain a variety of symptoms arising from 
a single primary cause. 

As the purpose of the book is pre-eminently 

vi 



Preface 

practical, the author felt warranted in describing 
minutely his own clinics, so far as any patient 
could apply the results to his individual needs. 
This, therefore, is the author's excuse for intro- 
ducing his own appliances and describing their 
features and uses. Certain work must be done 
by the sufferer himself, and no other invention in 
the market will aid him so materially in doing this 
work scientifically and efficiently. 

Furthermore, it was found impossible for the 
author to describe what he himself was doing as a 
rectal specialist, or to direct sufferers on the road 
to relief, unless he stated how certain appliances 
should be employed. In the following pages, con- 
sequently, the reader will learn just what to do, for 
the work is above all things simple and direct, and 
in the writer's judgment has the sterling quality of 
common sense. 

Some of the chapters have already appeared, in 
abridged form, in the magazine Health, as contrib- 
uted essays ; but the text has been elaborated in 
the following pages and much new matter added, 
in order that the work should present the most 
mature information concerning the subjects dis- 
cussed. 

A. B. J. 

New York, March 2, 1914. 



CONTENTS. 



CHAPTER I. 

Efforts to Overcome Constipation without Seek- 
ing its Cause i 

CHAPTER II. 

Pathology of the Anus and Rectum ; or, The Gen- 
esis of Constipation 8 

CHAPTER III. 
The Formation of Channels, Piles, and Fistulas . 19 

CHAPTER IV. 

Undue Retention of Gas and Feces in the Sigmoid 

Flexure 28 

CHAPTER V. 
Rebellion of our Outraged Internal Economy . 35 

CHAPTER VI. 
Gaseous Obesity and our Roly-polies ... 46 

CHAPTER VII. 

Irrigation of the Assimilative and Eliminative 

Organs 57 

CHAPTER VIII. 
Methods of Stomach Cleansing 65 

viii 



Contents 

CHAPTER IX. pag« 

When Enemas should be Taken . . . . 72 

CHAPTER X. 
How Enemas should be Taken . . . . . 84 

CHAPTER XL 
The Internal Fountain Bath 90 

CHAPTER XII. 

Benefits of the Inner Bath 101 

CHAPTER XIII. 
Objections to the Use of the Enema Answered . 108 

CHAPTER XIV. 
Lame Back . 121 

CHAPTER XV. 
Uric Acid 126 

CHAPTER XVI. 

Rational Sanitation and Hygiene .... 136 

CHAPTER XVII. 

Personal Cleanliness 145 

CHAPTER XVIII. 

Hot Water in the Treatment of Proctitis and 

Colitis 152 

CHAPTER XIX. 

Hot Water in the Treatment of External 

Symptoms 162 

CHAPTER XX. 
The Health of School Children . . . .165 



1* 



Contents 

CHAPTER XXI. 

Internal Hemorrhoids or Piles versus Mucous Sac, 

Recto-Anal Mucous Sac 171 

CHAPTER XXII. 

External and Thrombotic Piles versus Muco- 
cutaneous Sac and Thrombus .... 181 

CHAPTER XXIII. 

Abscess and Fistula Involving Anus, Rectum and 

Neighboring Regions 190 

CHAPTER XXIV. 

Nine Radiograph Illustrations Showing Mucus 

Channels and Cavities 200 

CHAPTER XXV. 

Chronic Mucous Proctitis and Sigmoiditis — Usu- 
ally Diagnosed as Chronic Mucous Colitis . 202 

CHAPTER XXVI. 
Antiseptic Employment of Powders and Oils . . 208 



INTESTINAL IRRIGATION. 



CHAPTER I. 

Efforts to Overcome Constipation without 
Seeking its Cause. 

IN the year 1496 an Italian, Gatenaria, invented 
an appliance for taking an enema ; since that 
time depuratory instruments have had more or less 
vogue in all civilized countries. Of late years in- 
ventive powers have been taxed to construct more 
convenient and effective appliances, and now per- 
fection has been almost reached, and the poor civili- 
zee, whose habits are really very bad from the 
savage point of view, may enjoy the delicious privi- 
lege of an internal bath whenever he feels the need 
of it. By any other name this bath is just as puri- 
fying : call it irrigation, injection, lavement, clyster, 
enema — its many names and what they mean 
testify to the fact that it is for the disease of civili- 
zation. 

The medical profession is really behind the lay- 
man in genuine therapeutic measures. It still cares 
more for the pill-and-powder-prescription-earning 
fee than for the real health of the patient. When 



Intestinal Irrigation 

it shall wean itself from its sordid commercialism, 
it will make the use of the enema a fundamental 
factor in most forms of therapeutic treatment, and 
then the enema will become universal. 

From the origin of the enema to the present day, 
the layman has not been unmindful of this valuable 
resource for removing morbid matter from his 
physiological sewer. The great relief he thus ob- 
tained, and the invariably good results that followed 
its use, established as a necessary toilet article some 
form of depuratory apparatus in many homes for 
all time to come. 

But of the nature of the disease that had occa- 
sioned its use, both layman and physician were, and 
for the most part are, ignorant. Local obstruction 
and discomfort were sufficient to suggest this mode 
of relief ; yet no truly scientific inquiry seems to 
have been instituted to discover the cause of the 
obstruction. The author, during an experience of 
over twenty-three years as a specialist in diseases 
of the bowels, rectum, and anus, has found the true 
cause, namely, Proctitis ; that is, the chronic in- 
flammation (dating often from infancy and child- 
hood) of the anus, rectum, and frequently of a 
portion of the sigmoid flexure and colon. Proctitis 
is practically the universal cause of chronic consti- 
pation. Victims of constipation have more or less 
haphazardly resorted to the enema as a ready means 
of relief — a recourse that was often, nay generally, 
against the advice of their medical counselor : a 
professional opposition that indicates either ig- 



Efforts to Overcome Constipation 

norance, mistaken judgment, or fear of losing a 
profitable patient. But the layman has not been 
uniformly wise. He is an experimenter on his own 
hook — encouraged in his experiments by the most 
promising and seductive of advertisements in the 
whole gamut of advertising. He experimented on 
his organism, tinkering it now with cathartics or 
purgatives of multiform nature, and again with 
digestive and other agents. This tinkering habit 
seems to have become all but universal with civil- 
ized man. Constipation — which is caused by 
proctitis — will, of course, bring indigestion and 
biliousness and diarrhea and nervousness and 
headache and a host of other maladies in its train ; 
all of these induce the civilizee to increase his tin- 
kering with his divine abode until it eventually falls 
in ruins. The tinkerer loses sight of the fact that 
his abode is not a body like the bodies of wood, 
stone, and iron that he handles and putters with 
daily ; he forgets or ignores the fact that it is a 
vital organic machine, which, when tinkered too 
much, will stop, " never to go again." It is poor 
consolation when you have reached your last gasp, 
after a chronic invalidism, to feel that you have 
done the best you knew how. You have not sought 
the cause, nor, having learned it somehow, sought 
to remove or avoid it. For the last four hundred 
years this tinkering, this futile medication, has been 
kept up at a furious pace without even a hope of 
permanent cure. Poor, outraged human nature 
dimly knew that it was simply doctoring a symp- 



Intestinal Irrigation 

torn, a consequence of something or other — for that 
is all that constipation and its host of symptoms 
really are. 

The writer is of the opinion that constipation is 
the fundamental disease that afflicts mankind ; that, 
at all events, there are more cases of proctitis than 
of any other disease ; that very few " civilized " per- 
sons are free from it ; that so prevalent a disease 
must have a common origin, which he traces right 
back to babyhood, to the wearing of soiled diapers, 
a practice that cannot but result in inflammation of 
the buttocks and mucous membrane of the anus 
and rectum ; and that this inflammation continues 
and finally becomes deepened and established, pro- 
ducing in after years chronic constipation and its 
train of evils. Of course, there are other causes 
that bring on proctitis among children and adults ; 
but careful examination shows that the severity of 
the malady with its train indicates long duration in 
the tissues comprising the wall of the anal and rectal 
canals and the adjoining tissues of the bowels. 

Proctitis, with its extension, colitis, is by no means 
a slight disease, as it is supposed to be by a few mem- 
bers of the medical fraternity who are beginning to 
apprehend its existence ; on the contrary, it is so 
serious that its gravity cannot be impressed too 
forcibly upon both laymen and physicians. During 
the many years of special attention the writer has 
given to diseases of the anus, rectum, colon, etc., 
he has not ceased to wonder how it was possible 
that the victim of deep-seated proctitis could have 



Efforts to Overcome Constipation 

so dreadful a disease and not be greatly alarmed 
at its ravages and dangers. The anatomy, physi- 
ology, and hygiene of the parts involved in this 
inflammation continue in some manner to permit 
the passage of excrement along the diseased canal ; 
and the victim continues to swallow drugs and 
tinker with these — his irreplaceable " inards." * 

It is not my purpose at present to go into a de- 
tailed description of the organs involved in this 
inflammatory process, but to make plain why the 
enema is superior to all other means of securing 
cleanliness. When we know why we do a thing, 
the task is not so difficult and annoying as when we 
go it blind or simply obey the behest of a physi- 
cian. Ignorance has no business bothering with 
anything ; experience, however, is usually a painful 
if not a fatal instructor. The human race at large is 
ignorant concerning the normal and abnormal pro- 
cesses of its internal organs. " Out of sight, out of 
mind " seems to be the maxim of almost every one 
as to our vital organs and the conditions for their 
hygienic functioning. The purpose of the writer 
will be achieved if he succeed in sounding a note 
of warning that will be heard and heeded by those 
whose influence will extend the echoes till the world 
listens and learns the claims of the inner physio- 
logical economy. 

Those that possess even a modicum of sense will 

1 For numerous illustrations of the various morbid conditions of the 
anus and rectum, see the author's 64-page booklet, entitled How to Become 
Strong. 



Intestinal Irrigation 

easily understand how a muscular tube like the 
anus, rectum, sigmoid flexure, etc., when invaded 
and traversed for eight to ten or more inches by 
disease, will offer obstruction to the descent and 
escape of gases and feces. All are familiar with 
the contraction that occurs when a finger, hand, or 
limb is inflamed ; how little we can then use the 
diseased part until all of the inflammation has left 
the muscular tissue. Why do we give so much 
attention to an inflamed external part and none at 
all to the all-important internal organ for the ex- 
pulsion of the sewage of the body ? The parts are 
not "weak" when contracted with inflammation: 
weakness is not what is the matter with them. The 
trouble is that the muscular fiber is then too active, 
made so by the excessive irritation of the local dis- 
order. Irritation of muscular tissue always causes 
contraction of its fiber. Such contraction well 
accounts for constipation. 

We are a nation of constipated people, so consti- 
pated indeed that we have developed dyspepsia and 
neurasthenia. As I have already stated, the chief 
ill of " civilized " people is proctitis ; the chief symp- 
tom of proctitis is constipation ; the chief symptom 
of constipation is dyspepsia ; and the chief symp- 
tom of dyspepsia is neurasthenia, and so on and 
on — all of them the outcome of imperfect elimina- 
tion of morbid matter from the intestinal canal. 

The common sense learned in the treatment of 
external parts should be applied to such diseased 
portions of the body as the anus, rectum, etc. 

6 



Efforts to Overcome Constipation 

Common sense declares that an enema ought to be 
used on all occasions of undue retention of the con- 
tents of the bowels. It is the only sensible thing 
under the circumstances. Yet, for the last four 
hundred years, only independent men and women 
have had the courage to proclaim its merits, since 
the subject was under the ban of both laymen and 
physicians. Now that we have learned the abso- 
lute necessity of such a device, it is to be hoped 
that the taboo will be removed, and that the numer- 
ous victims of proctitis will be instructed in the 
wisdom of availing themselves of the valuable aid 
of the enema in either curing proctitis or prevent- 
ing it from growing worse, while they are at the 
same time securing relief through its use by the re- 
moval of feces and gases several times daily, thus 
preventing the absorption of poison, which the 
retention of waste invariably facilitates. 



CHAPTER II. 

Pathology of the Anus and Rectum ; or, The 
Genesis of Constipation. 

WHEN an affliction is seemingly universal it is 
reasonable to conclude that it springs from 
universal conditions. Proctitis, the most wide- 
spread disease of civilized man, originates very 
early in life, and develops in after years numerous 
painful symptoms — such as piles or hemorrhoids, 
constipation, etc. 

Now, what is the most common exciter of procti- 
tis, which, as has been said, is an inflammation of 
the mucous membrane of the anus and rectum ? 
In my earlier work, Intestinal Ills, I have shown 
that inattention to the soiled diaper is generally the 
original cause of this most grievous of ills, with its 
train of malign consequences continuing through- 
out the victim's life on earth. Unnoticed by nurse 
or mother, the inflammation of the anus and rectum 
makes headway with each subsequent soiling ; and 
thereafter, when the use of the diaper is dispensed 
with, inattention to the normal action of the bowels, 
improper food, the resort to purgatives, stimulants, 
and opiates, play no small part in aggravating the 
existing malady. 




Fig. i. 



A portion of the wall of the rectum has been removed exposing various 
layers : I, serous layer ; 2, muscular layers ; 3, 3, submucous layers ; 4, 4, 
mucous membrane ; 5, internal sphincter muscle ; 6, external sphincter 
muscle ; 7, circular muscular bands forming the rectum ; 8, rectum ; 9, 
sigmoid flexure. (See Fig. 7, showing the longitudinal muscular bands.) 



Intestinal Irrigation 



The first care-taker of the infant is therefore re- 
sponsible for the initial process, which progresses 
to a chronic condition by subse- 
quent inattention. She is indeed 
solicitous over the inflamed but- 
tocks of her charge, but overlooks 
the far more dangerous inflam- 
mation of the mucous membrane 
of the anus and rectum, or she 
does not realize its insidious 
and subtly progressive charac- 
ter. Candidates for motherhood 
should be instructed on this mo- 
mentous subject. 

There are other exciting causes 
of proctitis, but, since they are 
exceptional when compared with 
the neglected diaper, we need 
not concern ourselves with them 
at present. 

The muscular coat of the rec- 
tum consists of two layers : an 
inner circular and an outer longi- 
tudinal band. The inner circular 
layer of muscular tissue of the 
rectum forms the internal sphinc- 
ter muscle ; and the outer longi- 
tudinal bands mergfe with those 
of the external sphincter. The 
anal orifice is closed or guarded by two strong 
sphincter muscles, as shown in Figs, i, 2, and 3. 




Fig. 2. 

#, Ulcer on sphincter 
ani. b, Filaments of 
two nerves are exposed 
on the ulcer, the one a 
nerve of sensation, the 
other of motion, both 
attached to the spinal 
marrow, thus constitut- 
ing an excito-motory ap- 
paratus, c, Levator ani. 
d, Transversus perinei. 
(Hilton.) 



10 



Pathology of the Anus and Rectum 

These muscles are abundantly supplied with nerves, 
of which branches are distributed to the bladder 
and other adjacent organs, which accounts for the 




Fig. 3. 
a, Sacrum, b, Coccyx, c, Tuberosity of ischium. d, Posterior or 
larger sacro-sciatic ligament, e, Anterior or small sacro-sciatic ligament, 
with the pudic nerve passing over its posterior aspect, and proceeding to the 
rectum and penis. /, Sphincter ani receiving its nervous supply from the 
pudic nerve. Portions of the muscles have been cut away, in order to 
show nerve filaments going to the mucous membrane, through the muscular 
fibers, g, Levator ani. h, Fat and areolar tissue occupying the ischio- 
rectal fossa and covering the levator ani. i, Transverse muscles of per- 
ineum, k, Erector penis. /, Accelerator urinse. I, Pudic nerve. 2, 
Posterior sacral nerves proceeding to posterior part of the coccyx and to 
the sphincter ani. 3, Anterior sacral nerve (4th) supplying the sphincter 
ani. (Hilton.) 

sympathy of these organs and their grave dis- 
turbance when disease inheres in the anus and 
rectum. 

The orifice used for the elimination of undigested 

food and waste matter plays quite as important 

a part in the organic economy as the orifice that is 

employed for receiving food. Normal elimination, 

11 



Intestinal Irrigation 

physiological and psychological, is the correlative 
process to prehension (seizure or appropriation), 
and the concord of the two forms the key-note of 
the organism. 

The muscles and tissues constituting the anal 
vent should be as flexible and responsive to the 
will or desire of the rectum for relief of its contents 
as the lips are in permitting the saliva to escape. 
In like manner the upper portion of the rectum 
(Figs. 6 and 8) should respond with instant readi- 
ness to the effort of the sigmoid flexure to expel its 
contents. But an abnormal condition like inflam- 
mation rooted in the anus and lower part of the 
rectum (Fig. i, 4-4) will inhibit the passage of 
the pressing burden above them, which inhibition 
will cause the inflammation to extend to the sig- 
moid flexure, and thence on to the colon proper ; 
and sooner or later the inflammation will penetrate 
the sub-mucous coat (Fig. 1, 3-3), which is com- 
posed of fatty or areolar connective tissue in which 
trunks of nerves and blood-vessels are imbedded. 

The first symptom of inflammation is undue red- 
ness, followed by slight puffiness of the anal and 
rectal mucous membrane (Fig. 1, 4-4), with more 
or less sensitiveness of the tissues involved ; and as 
its irritability increases there is more or less con- 
traction of the muscular tissue forming the anus 
and rectum, which lessens the diameter of their 
bore. And the consequence of this contraction is 
of physiological concern to the victim, for in pro- 
portion to the contraction the normal demand of 

12 



Pathology of the Anus and Rectum 

the victim for relief of the impending feces and gas 
is modified and lessened. 

In health, the anal canal is from two to three 
inches in length, and it will distend about two 
inches — an elasticity quite equal to that of any 
other orifice of the body. As the anal tissues are 
usually the first to be invaded by disease, it is but 
natural that the obstipation or constipation should 
occur right above it — namely, in the rectum. The 
average length of the rectum is about six inches, 
and when the disease invades its whole length the 
constipation occurs in the sigmoid flexure and may 
thence extend to the colon. 

The filling of the intestine with feces and gases 
usually occurs just above the diseased portion of 
the gut ; but at the same time the walls of the 
affected part of the canal are more or less coated 
with feces, and its abnormal pouches here and there 
contain more or less liquefied or dried feces. A 
diseased canal cannot expel all of its contents, since 
its normal expulsive power is gone. Some of the 
feces somehow or other gets down and out, but 
a larger portion inevitably remains. It is for this 
reason that a diseased intestine always reminds one 
of the Augean stable. It is simply marvelous that 
the human body continues as a living organism 
with so much filth and bacterial poison stored in 
its alimentary canal, and the vaults that result 
from abnormal pressure during periods of fecal 
impaction (Fig. 4). 

When the inflammatory process extends up the 

13 



Intestinal Irrigation 

rectum and at the same time into the spongy, fatty, 
or areolar tissue under the mucous membrane (Fig. 
I, 3-3), thence to the muscular and serous layers 
(Fig. 1, 2-1), or through the four layers of tissue 
comprising its wall, we have a more marked and 
serious occlusion (closing) of the organ than when 
only the mucous membrane was affected. When 
muscular tissue is inflamed, its tendency is to con- 
tract and become solidified by an adhesive inflam- 
matory product secreted between the circular and 
longitudinal muscular fibres (Fig. 1, 7, and Fig. 7). 
Often the circular or sphincter muscles forming the 
anal canal have to be distended to bring about a 
more normal vent. The same pathological condi- 
tions that occasion contraction of the anal bore or 
caliber occur, more or less, as far up the gut as the 
disease has advanced. 

In a normal state of the lower bowel the sigmoid 
flexure passes its contents into the rectum, and the 
desire to defecate is reported — that is, the impulse 
to stool becomes more or less urgent until it is per- 
formed. But when all four coats of the anus and 
rectum are diseased, with perhaps a portion of the 
sigmoid flexure also, it is very difficult for the healthy 
portion of the sigmoid flexure and the colon to dis- 
charge their contents into the rectum ; consequently 
no call, impulse, or desire reaches the mind. Consti- 
pation will then ensue, for the stool, not being called 
for, is not performed. Every demand of a healthy 
portion of the intestine is answered by increased 
contraction of the muscles of the diseased portion 

14 



Pathology of the Anus and Rectum 

of the rectum. While the war between the healthy 
and the diseased sections of the bowels goes on, 
the victim naturally concludes that there is no occa- 
sion or demand for defecation, and he attends to 
other affairs, ignorant of the fact that he is thus 
making a fatal mistake. 

The first condition that ensues is the tendency of 
the rectum to fill unduly with feces and gases, im- 
pelling the victim to " strain " in order to force the 
feces through the constricted anal canal. After a 
while the sigmoid flexure and colon will fill unduly, 
and then the victim will form the habit of waiting for 
the feces to descend, and of straining to expel what 
little manages to escape through the diseased gut. 

A portion of the imprisoned feces in the healthy 
section of the intestine sometimes, at an unguarded 
moment, manages to distribute itself along the 
length of the diseased and constricted canal, where 
it is retained indefinitely, increasing the local irrita- 
tion. And when the fecal mass accumulates suffi- 
ciently in both the healthy and the diseased portions 
of the intestines to set up a vigorous excitement, 
the victim may, by the aid of his waiting and strain- 
ing habit (which habit, by the way, only torments 
and bruises the chronically diseased organs), bring 
on some sort of evacuation. In the early history 
of the disease this habit may serve for a time ; but, 
as the disease progresses, the ''laxative" habit is 
formed, which, in turn, settles into a chronic " drug" 
habit for all sorts and conditions of gastro-intestinal 
and other ills, which inevitably ensue. As the rav- 

15 



Intestinal Irrigation 

ages of chronic inflammation of the anus and rectum 
increase, the symptoms rapidly multiply, till finally 
the victim, in desperation, feels that he must find 
additional sources of relief — and, among other habits, 
he forms the " diet " habit. 

The order of abnormal habits brought into exist- 
ence by ulcerative inflammation of the anus, rectum, 
and colon is about as follows : (i) the habit of un- 
duly retaining the feces in the rectum ; (2) the 
habit of straining at stool ; (3) the habit of unduly 
retaining the feces in the sigmoid flexure ; (4) the 
habit of resorting to the use of purgatives, pepsin, 
and other drugs ; (5) the chronic " physic " habit ; 
(6) the foolish " diet " habit ; (7) the gastroin- 
testinal neurasthenic habit ; (8) the health-resort 
habit ; (9) the habit of trying desperately to appear 
agreeable while feeling really ill ; (10) the habit of 
blaming the liver for all direful feelings, physical 
and mental. 

It is but natural that the lower portion of the 
rectal and anal structures should be affected more 
severely than any other portion of the intes- 
tines by the ulcerative, inflammatory process. The 
sphincter muscles are very strong, as a rule, and 
fill their office only too well when the anal and 
rectal canals are in a diseased state, for they effec- 
tually prevent the contents from escaping. Often 
their contraction or stricture is so great that their 
expansion is limited to from one-fourth to one-half 
an inch. This virtually permanent closure of the 
anal vent naturally results in an accumulation of 

16 



Pathology of the Anus and Rectum 



feces just above it, or in the lower portion of the 
rectum, which accounts for the dilatation, stretch- 
ing, or ballooning of the anal and rectal tissues im- 
mediately above 
these muscles, as 
shown in Fig. 4. 

In not a few 
cases where dila- 
tation of the rec- 
tum exists, the 
upper half or 
more of the anal 
canal is also di- 
lated, leaving an 
anal canal only 
an eighth of an 
inch in length in 
some cases ; in 
other cases, per- 
haps half an inch 
to an inch. 

Similar dilata- 
tion of the sig- 
moid flexure occurs as the result of the severe con- 
traction of the upper half of the rectum, and especi- 
ally at the bend shown by Fig. 6 and Fig. 12. 
This bend forms quite a sphincter for the normal 
receptacle — the sigmoid flexure. Here also pro- 
lapse, distention, and dislocation of the sigmoid 
flexure may occur, somewhat similar to the anal 
prolapse from disease and abuse. 




Fig. 4. 
1, The dotted lines indicate the normal direc- 
tion of the anus and rectum ; 2, 4, the cavities 
or pouch formed by dilatation or ballooning 
from the storage of impacted feces ; 3, a probe 
bent at right angles, and introduced through 
a speculum, to ascertain the depth of the 
pouch, which is frequently found to-be two 
and a half inches. 



Intestinal Irrigation 

Piles and itching of the anus are symptoms of 
proctitis, or inflammation of the anus and rectum. 
Why should we find such dissimilar symptoms pro- 
ceeding from the same cause ? The reason is plain 
when we consider the results following chronic in- 
flammation of the mucous membrane of the anus 
and rectum and the deeper tissues. Those who 
suffer from catarrh of this membrane are familiar 
with the discharge of mucus that appears from 
time to time during the progress of the inflamma- 
tion. But, as the inflammation penetrates the mu- 
cous membrane and the underlying tissues of the 
anus and rectum, the escape of the inflammatory 
product is prevented ; and this imprisoned fluid 
must either be absorbed by the system or retained 
in reservoirs or in channels wherever the least re- 
sistance is offered to its invasion. 

The mucous membrane of the anus and rectum 
is loosely attached to the subjacent parts by areo- 
lar tissue (Fig. i, 3-3), which is sufficiently lax to 
allow an expansion of two inches ; and in a puck- 
ered or contracted state the membrane is thrown 
into folds, or into shallow or deep wrinkles. The 
loose areolar attachment and folds of various depths 
afford space for lodgment of the inflammatory dis- 
charge, which channels its way down along the 
folds through the areolar tissue under the mucous 
membrane to that of the integument, and so on for 
a distance of a foot or more from the anus in some 
cases. 



is 



CHAPTER III. 

The Formation of Channels, Piles, and 
Fistulas. 

SHOULD channels, of varying length and num- 
bers, form early in the development of procti- 
tis, the sufferer is usually found to be free from 
piles, or hemorrhoids, for the reason that the chan- 
nels have afforded an outlet to the inflammatory 
product. The formation of lengthy channels also 
prevents to a great extent the development of 
skinny tabs round about the integument of the 
anus. This is some compensation to the sufferer 
for the labor of scratching and for enduring the 
painful itching so often present. Some suffer only 
from pain along the channels themselves, while 
others experience a slight disturbance of the nerv- 
ous system ; yet all must be more or less poisoned 
from the absorption of so large an amount of the 
contents of the channels and cavities. 

In the cavities and along the channels the areo- 
lar tissue is of a mahogany color, and no channel 
is traced to its end so long as the tissues present a 
bruised, inflamed appearance. In some cases the 
inflammatory product has destroyed the areolar 
tissue attached to the integument at and near the 
anus, frequently to the extent of leaving a hollow 

19 



Intestinal Irrigation 



zy 



space or cavity of surprising dimensions. I have 
met only a few cases in which the channels were 
opened by pus forming in them. Those that are 
very shallow, the walls being friable, may break 
and form a fissure of the anus ; or a little anal fis- 
tula may arise from a slight suppuration at its end 
in the integument near the anus. 

In cases where the channels are few and short, 
whether itching be present or not, the pile tumors 
are likewise few and of moderate size, demonstrat- 
ing the intimate relation of the aggravation of 
either of the symptoms or the moderation of both 
in the same case. Very frequently pile tumors 
have channels extending from them to the junction 
of the mucous membrane and integument of the 
anus, or even under the integument about the 
anus, forming rugae, or tabs. 

The number and size of pile tumors would seem 
to depend on how completely the inflammatory 
product is imprisoned in the tissues in what is 
termed the " pile-bearing " region. Often the treat- 
ment of piles, or hemorrhoids, aids very much in the 
cure of itching at the anus — by destroying a part 
of the channels involved in the pile structures in 
the mucous membrane of the lower end of the rec- 
tum and extending alone under the anal membrane 
and the integument of the anus. 

The meshes and layers of the mucous membrane, 
as well as the space occupied by the areolar tissue, 
are stretched or pouched by the inflammatory 
product. 

20 



Channels, Piles, and Fistulas 

My observation forces me to conclude that the 
inflammatory product imprisoned in the areolar 
meshes, between the mucous membrane and the 
muscular layers, is the principal factor in forming 
piles and the channels so often found in the same 
region. Of course, obstructed circulation, con- 
gested veins, capillaries, and arterioles, and a more 
or less apparent varicose condition, increase the 
size of the pile tumors and the general thickness 
of the mucous membrane over the region affected 
by the disease. 

The process occasioning the separation of the 
mucous membrane from its areolar attachment or 
bed often extends the whole length of the rectum, 
giving the mucous membrane the loose and raised 
appearance that a piece of thin silk would have if 
laid on over that surface. The fatty or areolar 
tissue under the skin about the anus suffers like- 
wise by being destroyed, leaving a hollow cavity 
or a large channel of great length under the skin. 
The separation of the mucous membrane and in- 
tegument about the anus from their areolar attach- 
ment permits of prolapse of the mucous membrane 
and integument that form the anal canal and skin 
around the orifice. 

It would seem that the channels, pile sacs, and 
cavities serve as temporary reservoirs for the inflam- 
matory product, a portion of which the system 
absorbs and another portion of which escapes 
through the mucous membrane and integument. 
In escaping in this way it occasions itching and 

21 



Intestinal Irrigation 

pain. The itching or soreness does not in all cases 
extend throughout the whole length of the channel. 
A few inches of the channel farthest from its origin 
may be the seat of the greatest disturbance, and the 
sufferer and physician alike are usually unaware 
that the source of the trouble is in the tissues of 
the anus and rectum. 

The marked improvement in the health of those 
that have been cured of both the morbid condition 
produced by the inflammatory product and the 
cause of that condition is evidence that the general 
vitality of the system had been greatly lowered, 
even though the most annoying of the symptoms, 
such as piles, itching, or acute pain, had not been 
present. The lack of annoyance along the channel 
for a certain period may be due to a limited pro- 
duction, or to a rapid absorption of the inflamma- 
tory product by the system. 

Proctitis and the attendant symptoms just de- 
scribed have been overlooked by the medical 
profession. Physicians have confined their atten- 
tion to two symptoms — piles and fistula. After 
undergoing a surgical operation for these, the pa- 
tient is considered cured. What ignorance, or 
rather short-sightedness, to remove only the annoy- 
ing symptom, and then to pronounce the patient 
healed ! Let me ask my professional brethren why 
they do not concern themselves with the underlying 
cause of the symptom or symptoms, and whether 
they suppose this cause is going out of business. 
Surely it is a grave mistake to concern one's self 

22 



Channels, Piles, and Fistulas 

with the leading symptom merely — to remove that, 
and to leave its cause intact. When the disease- 
producing cause remains to generate its poisonous 
effects in the system, opportunities exist for further 
symptoms to develop. 

The system may be already depleted of vitality, 
and the harsh treatment for the purpose of remov- 
ing a mere symptom may only make the sufferer's 
condition more deplorable — if it does not indeed 
cause death. 

There are other symptoms of proctitis than piles 
and fistula, which remain after the conventional 
surgical operation for their removal. Obstipation 
and constipation are usually symptoms of proctitis, 
and will persist until the inflammation in the upper 
half of the rectum and sometimes in a portion of 
the sigmoid flexure is cured. 

The victim of proctitis has two marked sources 
of poisoning of the system : one proceeding from 
the absorption of the inflammatory product, and the 
other from undue retention of the waste matter of 
the body that should pass out by the lower bowel. 

Inflammation of a mucous membrane causes 
structural changes in the tissues involved in the 
morbid process, and not infrequently it becomes the 
seat of a malignant disease. 

The reader may be familiar with the white, loose, 
alveolar (honeycomb-like) network of elastic tissue 
(called fat) just under the skin and mucous mem- 
brane. Consult in this connection the cut on page 24. 

The abdominal and pelvic organs are cushioned 
23 



Intestinal Irrigation 

or held in place somewhat by the network of fatty 
tissue that surrounds them, and the rectum is no 




Fig. 5. 
Male pelvic organs viewed from the right side (the right ilium and a por- 
tion of the ischium and the pubic bone, together with their soft parts, have 
been removed). 1, auricular surface of the sacrum ; 2, tuberosity of the 
sacrum; 3, ischium; 4, pubic bone; 5, psoas muscle; 6, erector spinal 
muscle ; 7, glutei muscles ; 8, obdurator muscles ; 9, external sphincter of 
anus; 10, rectum; 11, sigmoid flexure; 12, bladder; 13, ureter; 14, vas 
deferens ; 15, seminal vesicles ; 16, prostate ; 20, lateral vesicle ligaments ; 
21, hypo-gastric artery ; 22, hypo-gastric vein ; 23, external iliac artery ; 
24, abdominal aorta. (Boas.) 

exception to the rule. The outer or serous wall is 
surrounded by an abundance of loose areolar tissue, 

24 



Channels, Piles, and Fistulas 

which is divided into cellular spaces. When this 
tissue also is invaded by inflammation, the condi- 
tion is spoken of as periproctitis ; and we have a 
result somewhat similar to that which occurs in the 
areolar tissue just under the mucous membrane and 
integument, as previously described. 

As the inflammatory product is discharged into 
this spongy or fatty connective tissue it is slowly 
forced in some direction, which is naturally down- 
ward, if not too much obstructed by firm tissue ; 
at all events, it follows the line of least resistance 
and forms usually quite a large channel and several 
cavities along its course. The channel may begin 
at an elevation of four or more inches on the out- 
side of the rectum (Fig. 5). Should it form in 
front of the rectum, the seminal vesicles (15) and 
the prostate gland (16) would suffer greatly by its 
presence. 

As the inflammatory process burrows its way 
downward, it finally reaches the soft fatty connec- 
tive tissue under the skin. It then continues along 
this in one or more directions for a distance of two 
or more inches. Several of these long, large pus- 
less channels may exist for many years, or for a 
lifetime, without sufficient evidence of their exist- 
ence along their route accurately to locate them. 
Itching, pain, and color of the skin often indicate 
the presence of such a channel under the integu- 
ment. The author has frequently found large 
channels extending up along the outer rectal wall 
for four inches, and extending out into the deep 
25 



Intestinal Irrigation 

tissues of the buttocks in various directions, with- 
out making their presence and ravages known to 
the victim. 

Such numerous pathological conditions have led 
the author to conclude that an abscess just under 
the skin and the discharge of pus are merely inci- 
dents in the history of such maladies. Think of it : 
your body may be bored with channels or holes of 
varying diameters and lengths, while you yourself 
may be ignorant of what is occurring ! The mu- 
cous membrane may be lifted from the connective 
tissue for the whole length of the rectum, and the 
skin about the anus may also be in this condition. 
You know that your health is not good, but you 
are ignorant of the cause. The formation of pus 
at some period of the channel's inroads, or of an 
abscess, would seem a kindly act of Nature, for the 
presence of so serious a disturber to health would 
thus become known. 

I have not overdrawn this picture of periproctitis 
and of submucous tissue channels. The victims 
could scarcely be worse off than they are. I want 
boys and girls, young men and young women, to 
learn the facts concerning the local dangers of 
proctitis ; for, when they once realize the serious- 
ness of this disease because of its many grave 
symptoms, they will give it proper attention before 
these effects manifest themselves. You cannot 
neglect so important a portion of your body as the 
anus and rectum and not seriously endanger the 
organs that lie close to them. No wonder so many 

26 



Channels, Piles, and Fistulas 

men are troubled with inflammation and induration 
of the prostate gland. The percentage of such 
cases would be greatly reduced were proctitis and 
periproctitis denied the existence they now enjoy 
for years, and often for a lifetime. 

In view of all that has been advanced concerning 
these local pathological conditions, is it strange 
that almost everybody is constipated, and that we 
need some simple sovereign aid to further the 
scientific treatment of the physician — an aid such 
as the enema has proved to be ? 



27 



CHAPTER IV. 

Undue Retention of Gas and Feces in the 
Sigmoid Flexure. 

IN the previous chapters attention was called espe- 
cially to the lower portion of the rectum and 
the anus. In this chapter we will consider the sig- 
moid flexure, which, when diseased, is often dilated, 
dislocated, and depressed, a pathological condition 
somewhat similar to that found in the lower portion 
of the rectum and the anus. 

The illustration on page 29 shows the normal 
relations of the rectum and the sigmoid flexure ; 
also the whole colon. 7 marks the beginning of 
the sigmoid flexure, and 6 its upper end. The 
reader will note the four sharp curves or flexures 
of this organ, — from 6 to 7, — which forms in health 
a normal and most convenient receptacle for feces, 
and which, like the bladder, can be emptied at 
regular intervals. 

Unless the system were able in some way to 
eliminate the waste and poisonous matter it had 
generated within six hours, it would fatally poison 
itself. 

Those internal ventilators, the lungs, and those 
external ducts, the pores, are constantly at work 

28 



Retention of Gas and Feces 



purifying the body ; and they are actively assisted 
by the kidneys and the bladder. Observation ex- 
tending over many years of practice induces me to 
believe that among those 
who suffer from chronic 
constipation two-thirds 
to three-fourths of the 
fecal mass is taken into 
the system and elimin- 
ated by the kidneys, 
mucous membrane, and 
skin. Diseases of the 
above organs are num- 
erous and seemingly in- 
curable from the fact 
that their common cause 

has not been discovered 

i 1 i FlG - 6 - 

and treated properlv. T , T 

r ^f^ j- g_ The anus. Levator am muscle 
Were it not for these seen on each side. 8, 8. The rec- 

organs steadily at work, tum - 7 - Be § in " in § of the rectum - 

° r i ^' ^ ie s ig m °id flexure. 5. The 
the labor Of the bowels descending colon. 4. The trans- 
WOuld be Of little avail. verse colon - 3- The caecum, or caput 
B, . t , . coli. 2. Appendicula vermiformis. 
Ut While the import- t . T he end of the ileum. 

ance of the former can- 
not be ignored, it must be conceded that the most 
important of all the eliminating organs are the 
bowels, for their function is to discharge not only 
the waste solids but also a great amount of waste 
liquids and gases as well. 

Undue fermentation of the ingesta (the aliment 
taken into the system) generates poisons of more 
29 




Intestinal Irrigation 



or less virulence ; it must therefore be obvious 
that a clean intestinal canal is necessary after every 
meal to further the normal digestive process. 

Very often the outlet of the sigmoid flexure is ob- 
structed. Fig- 
ures 6 and 7 are 
shown to make 
the cause of this 
obstruction 
more clear. In 
Figure 7 we see 
the longitudinal 
and transverse 
fibers that form 
the wall of the 
rectum. In all 
cases of chronic 
obstipation, the 
muscular struct- 
ure of the anus, 
rectum, and fre- 
quently of a 
portion of the 
sigmoid flexure 
is invaded with 
chronic inflammation of a very severe and serious 
character. 

What is the result of this inflammation ? Self- 
evidently contraction of the muscular structure, as 
you would quickly enough discover were one of 
your hands or arms inflamed. 





Fig. 7. 

A view of the longitudinal muscular fibers of 
a section of the rectum : 2, upper portion of the 
rectum ; 3, 4, 5, the three bands of longitudinal 
fibers of the colon continued upon the rectum ; 
6, the longitudinal muscular fibers of the rectum 
formed by the expansion of those of the colon. 
A view of the muscular coat of the colon : 1, 
r, one of the bands of longitudinal muscular 
fibers ; 2, 2, the circular fibers of the muscular 
coat. 



30 



Retention of Gas and Feces 

Though constant attention should be given to 
the much more important organ, the rectum, prac- 
tically none is given it. " Out of sight, out of 
mind. 

Again, no doctor would diagnose an inflamed 
limb as paralysis, atony, etc., and dose the victim 
with nux vomica, tonics, physic, etc., in the hope 
of thereby healing it. Yet, with singular fatuity, 
this absurd diagnosis and treatment is given when 
the lower bowel is invaded with chronic inflamma- 
tion. 

Let the common-sense reader inform himself 
concerning his organism. Let him remember that 
he has within muscular organs that demand exactly 
the same attention when diseased as those without. 
This fact is especially important for the sufferer 
from constipation or semi-constipation to know. 

Were the anus, rectum, and sigmoid flexure one 
continuous straight tube, the muscular action in the 
process of defecation would not be as complex as 
it is, since then the feces would drop right down 
and out. But these parts have so many curves and 
angles that when disease invades their interior they 
accentuate their folds and valves by contracting and 
do not readily respond to the nerve demand for 
complex, muscular, snakelike movements, when 
evacuation is desired. I n this unreadiness to respond 
they cast into confusion all the functions of the 
whole complicated organism, all parts of which are 
necessarily interdependent. A wise provision of 
Mother Nature are these curves, angles, and valves, 
3i 



Intestinal Irrigation 

for they prevent the sudden dropping of the con- 
tents of the colon down to the anal orifice — a pos- 
sibility that would greatly embarrass us during 
social and business hours. 

The accompanying figure shows the rectum dis- 
sected at its upper end from the sig- 
moid flexure. This portion of the 
rectum is smaller than the lower 
two-thirds of the organ. Now, it 
is this lessened diameter of the gut 
that is an aid to the sigmoid flex- 
ure in its capacity as a receptacle, 
but a most decided hindrance when 
it is diseased — since it will posi- 
tively inhibit the passage of feces 
and gases, thereby occasioning a 
distention of the sigmoid flexure 
(obstipation) because of a detention 
of the contents, which then weights 
the flexure down upon the rectum. 
Thus we see exemplified how an 
aid may turn into a hindrance, as 
we already have observed, in an 
unduly contracted anal vent. 
The rectum is not straight, as the word itself 
would indicate, but curves to the right, then back 
well on to the spine, and then forward to the anus, 
which turns slightly backward from the lower ante- 
rior portion of the rectum. 

When these muscular-tube organs are invaded 
by disease, these very curves, valves, and bends of 




Fig. 



32 



Retention of Gas and Feces 

anus, rectum, and sigmoid flexure are responsible 
for at least nine-tenths of the ills that affect hu- 
manity from the cradle to the grave — ills directly 
due to self-poisoning, technically known as auto- 
infection and auto-intoxication, the fashionable 
name of which is neurasthenia : a weakening of in- 
voluntary and voluntary nervous systems through 
lack of vent from irritating poisons, flatulency, and 
of course defective metabolism or nutrition. A 
better name would be vaso-motor neurasthenia. 

After these anatomical and physiological points 
have been noted, it is to be hoped that the reader 
has grasped the idea of how easily this portion of 
the bowels, when diseased, can prevent the normal 
descent of the feces and gases accumulated just 
above the diseased portion of the gut. It should 
also be easy to understand how a portion of the 
unduly retained feces may pass out, but in so doing 
be the cause of increased irritation and consequent 
contraction of the muscular tube, preventing thus 
any further passage of feces from its receptacle. 
Usually a portion of the escaping feces is caught 
and held in the rectum itself, converting the rectum 
into a receptacle. 

It is just here that the practical application of 
the principles deduced must come in. Let my pro- 
fessional brethren as well as all victims of bowel 
disease consider the following question, and then 
all will be clear : Since normal feces contain about 
75 per cent, water, is there any harm, nay, is there 
not decided benefit, in suddenly liquefying the im- 



Intestinal Irrigation 

prisoned mass to, say, 99 per cent. — whether dis- 
ease exist or not ? 

When disease exists we simply desire to open 
the contracted or obstructed canal. What can be 
better, in a therapeutic line, than the kindly dis- 
tending influence of warm water to overcome the 
spasmodic closure of the diseased tube ? In addi- 
tion to the gentle dilatation the injected water oc- 
casions, the water creates or calls into activity the 
lost nervous impulse to evacuate, which impulse is 
a step toward the restoration of the lost normality. 

Under the benignant influence of the water in- 
jected in the large intestine there comes a desire 
to expel it, which, when responded to, carries with 
it the feces so long imprisoned, and at the same 
time divests the walls of the intestine of the inevit- 
able incrustations. 

Thus, with purifying water, the foul pool is 
emptied, and the parts are cleansed so thoroughly 
that nothing is left to vex the inflamed tissue. 

Is there any sane person that can offer one valid 
objection to the use of depuratory enemas in cases 
in which the normal function of the bowels is 
lost through abnormal changes brought about by 
chronic disease ? 



34 



CHAPTER V. 

Rebellion of our outraged Internal 
Economy. 

THE small intestine is that portion of the ali- 
mentary canal which begins at the stomach and 
ends at the large intestine. Its usual length is 
twenty feet. The diameter, which at the upper 
portion (duodenum) is two inches, gradually be- 
comes less, until at the lower end it is but one 
inch. 

Now, the length of the inner coat of this small 
intestine — the mucous membrane — is about double 
that of the intestine itself. Think of wearing a 
coat twice as long as yourself ! How do you think 
this is accomplished in the case of the muscular 
tube under consideration ? Well, Nature, having 
a most peculiar function to perform, has thrown 
this mucous coat or tube into a thousand folds (val- 
vulae conniventes, or "winking valves"). These 
folds form valves, occupying from one-third to one- 
half the circumference of the bowel. The greatest 
width of each fold is at the center, where it meas- 
ures from a quarter to half an inch. Over this 
great expanse of mucous membrane we find stud- 
ded ten million five hundred thousand intestinal 

35 



Intestinal Irrigation 

villi, whose office it is to absorb the food sub- 
stances in their passage through the canal. 




Fig. 9. 
Stomach, liver, small intestine, etc. (Flint.) 1, inferior surface of the 
liver ; 2, round ligament of the liver ; 3, gall-bladder ; 4, superior surface 
of the right lobe of the liver; 5, diaphragm; 6, lower portion of the 
oesophagus ; 7, stomach ; 8, gastro-hepatic omentum ; 9, spleen ; 10, gas- 
tro-splenic omentum; 11, duodenum ; 12, 12, small intestine ; 13, caecum ; 
14, appendix vermiformis ; 15, 15, transverse colon ; 16, sigmoid flexure of 
the colon ; 17, urinary bladder. 

Those that have observed the anatomical illus- 
trations of the small intestines must have been 
struck by their apparently inextricably tangled 

36 



Rebellion of our Internal Economy 



convolutions. In life, these convolutions are con- 
stantly changing their locations, as though they 
were a mass of worms. 

The large intestine begins at the caecum and ex- 
tends to the anus, or 
vent of the intestinal 
sewer. It is called 
the colon — the as- 
cending, transverse, 
and descending co- 
lon. It is about five 
feet in length. Its 
diameter is the great- 
est at the caecum, 
where it measures, 
when moderately dis- 
tended, two and a half 
to three and a half 
inches. Beyond the FlG IO 

Caecum tne diameter The caecum, dorso-mesial view, showing 

is One and tWO-thirds the ileum-side of the ileo-csecal valve, and 

-, i • i the beginning of the three muscular rib- 

to two and two-thirds bons (Gerrish } 

inches, the smallest 

part being at the upper end of the rectum. 

The muscular movements of the large intestine 
are much more limited in number and range than 
those of the small intestines. The area of its mu- 
cous membrane is also much less, notwithstanding 
the fact that it is thrown into sacculated pouches, 
or sacculi, by the contraction of the longitudinal 
muscular bands of the bowel. 




37 



Intestinal Irrigation 




Consider this tube, for it is really unique. Note 
the longitudinal muscular bands (Figs. 12 and 13). 
We find this tube to be five feet long when the 

surface made by the 
circular bands is 
measured, and four 
feet long when that 
made by the longi- 
tudinal bands is 
measured. Now, the 
four feet of surface 
must of course con- 
tract the five feet. 
Well, in the tube un- 
der consideration, 
the musculo-areolo 
mucous tube is 
thrown into circular 
puckerings in short 
sections, between 
which are deep trans- 
verse creases, each bounded by prominent bulges. 
(Fig. 13.) An inspection of the bore of the tube 
shows a sharp ridge corresponding to each depres- 
sion of the outer surface, and a large recess collo- 
cated with each external protrusion. This external 
and internal appearance of the large intestine re- 
minds one somewhat of the flexible hard-rubber 
tubing used as a conduit for electric wire in houses. 
The sacculated pouches thus formed by the 
shortening of the bowel may become abnormally 

38 



Fig. 11. 
Cavity of the caecum, its front wall 
having been cut away. The ileocecal 
valve and the opening of the appendix 
are shown. (Gerrish.) 



Rebellion of our Internal Economy 

distended, and resemble the proper receptacle for 
feces — the sigmoid flexure. Even the rectum, in 




Fig. 12. 
A view of the position and curvatures of the large intestine. 32, end of 
the ileum ; 31, appendix vermiformis ; 4, caecum ; 3, ascending, 2, trans- 
verse, 8, descending colon ; 9, 9, 9. sigmoid flexure ; 10, 10, rectum ; 12, 
anus; 13, 13, bladder ; 11, 11, 11, peritoneum — length from 4 to 6 feet, 
and a mean diameter of about if to 2f inches. The sigmoid flexure is a 
receptacle for the feces, and each end is the highest and bent on itself ; 
this arrangement spares the rectum and sphincters of pressure and weight 
until the proper time to stool. 

39 



Intestinal Irrigation 



MUSCULAR BAND 




i.MUSCULAR 
BAND 



muscular: 

BAND 



cases of chronic constipation, is usually enormously 
distended, owing to the overloading or filling up of 
the bowel with feces. 

I have given this somewhat lengthy risunti in 

order to enable 
the reader to 
appreciate a 
most pertinent 
question. 

Let us see 
what we have 
found : The 
small intestine, 
with its mani- 
fold folds and 
its numerous 
pockets, made 
by the forty 
feet of mucous membrane ; the bends and curves 
in the five feet of the lar^e intestine, with its 
numerous dams and pools ; and, lastly, the abnor- 
mal reservoirs for feces, liquids, and gases. 

Finding this, the question inevitably is, What is 
the best agent for cleansing this marvelously sensi- 
tive canal, twenty-five feet long, whose mucous 
membrane extends forty-five feet? No one would 
think of taking, if he could, the foul sewer in his 
hands, and shaking it, fold upon fold, with the faint 
yet fond hope of sterilizing it. How can any mode 
of physical culture meet the requirements for effect- 
ing a cure of ulcerative proctitis and colitis, to say 

40 



Fig. 13. 
Segment of large intestine, showing the char 
acteristic features of its structure. (Gerrish.) 



Rebellion of our Internal Economy- 
nothing about keeping the bowels sweet and clean ? 
Chronic, subacute, and acute inflammation, accom- 
panied with ulceration, located in any part of the 
body, requires rest to 
overcome the fever and 
congestion. Muscular 
exercise irritates and 
inflames the diseased 
parts. 

Another form of 
"physical culture" 
would put into the bow- 
els all sorts of stuff that 
cannot be digested, 
such as bran, crushed 
seeds, shells, raw food, 
etc., that set up exces- 
sive muscular action 




Fig. 14. 

A longitudinal section of the end of 

the small intestines, or ileum, and of 

the beginning of the large intestines, 

or colon. 1, 1, a portion of the ascend- 

and secretion of mu- in g colon ; 2 . 2 - the caecum, or caput 

.1 • coli ; 3, 3, lower portion of the ileum ; 

cus as the improper 4 _ 4 _ the muscuIa ; coat> covere db y the 

Stuff passes down and peritoneum ; 5, 5, the cellular and mu- 

out. In the sacred cous coats; 6 ' 6 ' folds of the mucous 

. coat at this end of the colon ; 7, 7, pro- 

name Of hygiene, this longations of the cellular coat into these 

new cathartic remedy folds ; 8 < 8 > ileo colic valve ; 9, 9. 

.. , * . the union of the coats of the ileum and 

is prescribed and taken. colon 
Seeking relief from the 

painful effects, the patient finds that these " reme- 
dies" make the disease and its symptoms worse. 
Hygienic fool-killers are, like the poor, always with 
us. 

You are aware of the irritation that a grain of 



41 



Intestinal Irrigation 

sand will set up when it comes in contact with the 
mucous membrane of the eye. Then can you not 
realize that you will torment the forty-five feet of 
intestinal mucous membrane with like indigestible 
stuff ? It is estimated that ten per cent, of the 
really suitable food is residue matter with which 
the digestive tract has to deal and get rid of with 
as much economy and as little friction as possible. 
Then why increase this residue twenty or fifty per 
cent. ? 

More than nine-tenths of the human race have 
been content to depend on comparatively violent 
excitants, such as drugs, coarse food, and muscular 
exercise, etc., to relieve the bowels of the feces, 
liquids, and gases of a most foul character — the 
foulness due to putrid fermentation and undue re- 
tention. 

When will these prescribers and partakers ever 
learn that bile bouncers and peristaltic persuaders 
have an immense journey before them when they 
start to remove the foul accumulation of feces from 
the sigmoid flexure and ballooned rectum ? For, 
be it remembered, the normal receptacle for feces 
is twenty-four feet four inches from the stomach, 
and the abnormal receptacle twenty-four feet eleven 
inches — within two inches of the vent of the body ! 

Surely quite a degree of mental constipation 
must have existed in both the prescribers and the 
partakers to think such thick and dense thoughts 
as are represented by these bouncers and per- 
suaders. So you would cleanse the bowels with 

42 



Rebellion of our Internal Economy 

such unclean, poisonous, and irritating things ! 
What amazing hope born of ignorance ! Outraged 
Nature cries: " How long! how long! how long 
will my ' inards ' be so abused in the name of clean- 
liness and yet remain so unclean ? Ye benighted 
mortals, if ye would listen to me, your Mother, I 
would give ye a pure and wholesome prescription, 
for I would prescribe equal parts of enlightenment 
and water well mixed, and advise ye to take a por- 
tion of it fore and a portion of it aft, per os (mouth) 
and per anus. Thus and thus alone would I pre- 
scribe for ye ; such and such alone is the way for 
ye to do ; purify to cure, or cure by purifying." 

Constipation must not continue, for it means not 
only the clogging up of the large intestine with the 
foul sewage of the system, but also the drying of 
that sewage, which latter process implies the ab- 
sorption of poison. Now that you are in this con- 
dition, Medicus steps up and prescribes a cathartic 
mixed with belladonna or opium, or both. These 
latter are meant to quiet the mournful cry of out- 
raged Nature when the cathartic invades its sacred 
precincts. And it may be noted, by the way, that 
though belladonna, atropine, morphia, etc., tend to 
dry up the secretions of the mucous membrane and 
make matters worse by making them still more 
arid, still the action of the cathartic is usually so 
powerful that after the free fight with the pain 
soothers it triumphs, and produces a free flow of 
watery secretion into the dried, impacted mass of 
the bowel. 

43 



Intestinal Irrigation 

Does it not stand to reason that the greater 
portion of the liquid in which the feces were dis- 
solved and had fermented is re-absorbed into the 
system ? Why should the poor victim of proctitis 
and cathartics wonder why he has gout, rheuma- 
tism, and disease of the kidneys, bladder, lungs, 
liver, stomach, nerves ; why he has neurasthenia, 
debility, feebleness, loss of memory, inability to fix 
and hold the attention upon a single line of thought, 
apprehensions, etc. ? His wonder is childish, for 
deep in his heart he knows that he poisoned him- 
self. He knows this, but it seems that he must be 
reminded of the fact that there is a better way to 
remove the accumulated mass from the large in- 
testine, and to prevent in future the undue reten- 
tion of feces, liquids, and gases in abnormal sacs 
or pouches. The way that Nature prescribes is 
the resort daily, two or three times, to the enema. 

When the injected water reaches the imprisoned 
and dried feces, the crust is loosened from its hold- 
ings and the mass is moved toward the exit by the 
expulsive effort of the bowels. Previously the 
bowels were helpless with their load. As the sud- 
den flood of water is expelled it carries with it the 
inspissated feces ; whereupon the subconscious per- 
sonal Ego, who is the superintendent of the diges- 
tive apparatus and functions, congratulates himself 
on the delightfully refreshing manner in which the 
local disturber has been ousted. 

Such is the satisfactory decision of the arbitrator 
— Enlightened Nature.. No longer need we bow 

44. 



Rebellion of our Internal Economy 

to Medicus or to any other kind of " cuss," whether 
styled hygiene or physical culture. Arbitration of 
this sort makes life worth living. 

Now for Nature's benediction : " May that feel- 
ing of freedom from uncleanliness, internal and 
external, be with you constantly, and this double 
blessing make your joys flow so fast that in their 
rapidity they blend into a sun and radiate from 
your rejuvenated physical being." 



4S 



CHAPTER VI. 

Gaseous Obesity and our Roly-polies. 

IS there any human being so ignorant that he can- 
not understand that when food stuffs in the 
gastro-intestinal canal ferment and putrefy they 
thereby generate toxic (poisonous) gaseous matter, 
volatile fatty acids, and putrid feces ; that such 
matter, acids, and feces are rapidly absorbed by the 
system, and that, if the system does not readily 
eliminate them by way of the bowels, kidneys, and 
mucous membrane, they will tend to bring on one 
or more forms of acute or chronic disease ? 

Gas is matter in its most rarefied state — a state 
that permits its easy entrance into all the tissues 
of the body, where it perverts by its presence and 
toxic effect the normal function of all the organs. 
Besides its poisonous infection, it distends or bloats 
the stomach, bowels, and tissues — a fact especially 
noticeable in the abdominal region, giving the ap- 
pearance of corpulency or obesity to many, when 
really it is only abdominal ballooning or gaseous 
obeseness. Roly-polies — and there are a great 
many of them — will have their pride greatly hurt 
by accounting for their condition in this way, but 
the truth must be told and they might as well face 

4 6 



Gaseous Obesity and Roly-Polies 

the facts first as last. Gaseous obesity, or bor- 
borygmus, is spoken of popularly as wind in the 
stomach and bowels. No wonder the roly-poly is 
sensitive on the subject, for this " wind " occasions 
rumbling sounds, eructations, and offensive odors 
— all of which are a great annoyance to the suf- 
ferer from dilated, displaced, and unclean digestive 
apparatus. 

Besides being generated in the system, gases 
may be swallowed during the act of eating, in the 
form of air (oxygen and nitrogen), and in liquids 
containing carbonic acid, sulphuretted hydrogen, 
etc. 

Micro-organisms swallowed with the food will 
occasion fermentation of the contents of the stomach 
and bowels, which if unduly retained become ex- 
cessive, foul, and toxic — therefore extremely harm- 
ful to the system. 

The gases generated in the stomach are the fol- 
lowing : carbonic acid, hydrogen, hydrochloric, am- 
monia, sulphuretted hydrogen, marsh gas, etc. 
They are partly absorbed or thrown off by eructa- 
tions, or they pass into the duodenum or small 
intestine. 

Gases are found throughout the small and the 
large intestine. These are the result of both the 
normal and the abnormal digestive fermentation 
and bacterial decomposition of the ingesta or food 
stuffs. Some of the gases are passed into the in- 
testines from the blood by diffusion. 

The production of gas is more copious in the 

47 



Intestinal Irrigation 

upper portion of the small intestine and becomes 
less rapid and abundant as the large intestine is 
reached. As formed or found in the intestines, 
the gases are : carbonic acid, hydrogen, marsh, am- 
monia, nitrogen, sulphuretted hydrogen, and sul- 
phate of ammonia. 

Considering the large amount of abnormal gases 
generated in the bowels and which abnormally dis- 
tend the abdominal walls for several inches and 
press upon the heart and lungs, and considering 
the small amount passed out as flatus, their en- 
trance into the tissues of the body must be very 
rapid and harmful. 

Stop the habitual putrefaction and mal-digestion, 
and then the formation of toxic feces, gases, and 
volatile acid will speedily cease. Then the erst- 
while roly-polies will shrink in circumference four 
or more inches, necessitating the refitting of their 
garments to the new and better order of things. 

Much has been written about the distention of 
the rectum, sigmoid flexure, and colon from the 
undue accumulation of feces. The fecal distention 
of the gut may extend along the intestine for from 
three to nine inches or more, which is a very grave 
matter indeed. But why is so much attention given 
to a few inches of impacted feces dilating a portion 
of the bowel, and none whatever to the prevention 
or elimination of gaseous matter that distends the 
whole gastro-intestinal canal to such an extent that 
the body is tightly inflated and the median parts of 
the belly bulge out like a balloon ? 

48 



Gaseous Obesity and Roly-Polies 

Cattle raisers are conversant with the gaseous 
inflation of their animals, and have to resort to the 
knife to puncture the stomach to permit the gas to 
escape ; otherwise fatal results would soon follow. 
Some animals, even, like most human beings, are 
intemperate in eating. When they consume too 
much grass they suffer from flatulency and colic, 
and require drastic treatment. 

Rather than let some worthy men and women 
die, ought we not at times to adopt the ranchman's 
treatment for flatus ? This harsh means, however, 
might be avoided by inventive science. Overfed, 
constipated, inflated man, victim of habitual flatu- 
lency, could easily have small gas valves inserted 
here and there along his gastro-intestinal canal — 
one, say, to relieve the stomach of toxic gas, another 
for the appendix region, and still another in the 
hernial region of the abdomen. Suppose overfeeders 
were to adopt the gas-valve fad, and discontinue 
the habit of using cathartics, soda, charcoal, pepper- 
mint, pepsin, whiskey, etc., as means of relief ! 
How in the world can a drug aid digestion when 
taken into a foul, gaseous, and feces-clogged canal ? 

A chemist cannot get the definite results he seeks 
unless he have the right chemicals and proper ves- 
sels. Just so with the spiritual Ego and his systemic 
chemistry of food : he needs a clean and healthy 
digestive apparatus for proper assimilation and 
elimination. But he gets careless, allows it to get 
foul, and then insincerely expresses astonishment 
that the chemical combinations are not such as one 

49 



Intestinal Irrigation 

could wish or expect. Other chemists, called doc- 
tors or druggists, come along and dose the poor 
victim of his own carelessness until they have 
ruined his apparatus completely. They have got 
to live, of course ; and it is their business to see 
that he does not escape so long as they can help it. 

Sometimes there is a reassertion of common 
sense ; the poor victim becomes disgusted with 
himself and his credulous acceptance of the doctor's 
dictation and his fatuous swilling of the druggist's 
decoctions. He gets tired of chronic ill-health and 
bowel troubles, and, lo and behold ! he does the 
simplest and most sensible thing in the world — a 
thing he ought to have done at the very start, or 
before he ever had the least trouble : He thoroughly 
washes out his alimentary canal with pure or anti- 
septic water. He drinks a lot of pure spring water, 
and he flushes his bowels with two or three enemas. 
Doctors and drugs are henceforth banished ; he 
gets well ! What a blessing to lose one's faith in 
the magic of drugs and the majesty of doctors ! 

Few comprehend the baneful effects of flatulency 
on the system, the most usual of which are fatigue, 
depression, headache, buzzing in the ears, deafness, 
vertigo, loss of memory, inability to fix the atten- 
tion, disturbance of sight, drowsiness, etc. A con- 
tinuous stream of carbonic acid or of hydrogen 
directed against muscular tissue will cause paralysis 
of the part. 

Physicians admit that in certain portions of the 
alimentary canal extensive dilatation may occur, 

50 



Gaseous Obesity and Roly-Polies 

independent of any permanent obstruction, in the 
lumen, or bore, of the gut. As a rule, however, vic- 
tims of proctitis and colitis suffer from more or less 
occlusion of the lumen in the region invaded by 
the ulcerative inflammatory process. 

Considering that the wall of the abdomen is often 
greatly extended by gas within the digestive ap- 
paratus, it is not amiss to assume that this gas may 
cause local distention of segments of the gastro- 
intestinal canal, sufficient to paralyze or render in- 
operative the parts. 

Suppose we make a rubber duplicate of the 
abdominal walls of the average man, and place 
therein rubber duplicates of all the internal vital 
organs — pelvic and abdominal. To hold the 
stomach, bowels, and other organs in place, we 
fasten them with elastic bands here and there, and 
make a generous use of cotton to support the vari- 
ous parts, which are all connected with many little 
circulating tubes, with strings for the greater nerves, 
etc. Now let us distend our thin artificial digestive 
apparatus with air or gas — snugly filling the ab- 
dominal space of our model, without tension, how- 
ever, or slackness of the various parts, which are 
happily adjusted and at rest. Now, be it remem- 
bered, persons suffering from flatulency are more 
or less in the predicament of the gluttonous animal 
referred to above : the gas will not escape at either 
end, however much of an effort it makes, or the 
victim may make to help it. 

In filling very slowly our thin artificial alimentary 

51 




Fig. 15. 
The stomach and intestines, front view, the great omentum having been 
removed and the liver turned up and to the right. The dotted line shows 
the normal position of the anterior border of the liver. The arrow points 
to the foramen of Winslow. (Gerrish.) 



52 



Gaseous Obesity and Roly-Polies 

canal, note the distention along the canal as the 
gas accumulates. Then note that the elastic bands 
stretch as the various segments of the canal change 
location, especially the stomach and portions of the 
small intestine and of the colon, etc. The stomach, 
small intestine, and colon, as they dilate, shift about 
for room. The abdomen is seen to bulge out some 
four or more inches while the turmoil is heard going 
on inside. 

Continue this inflation and our rubber intestinal 
tract will display here and there a displacement and 
permanent abnormal enlargement of the lumen or 
bore. Suppose, further, that our complete model 
of the abdominal viscera and wall had tightly 
around its outer surface unelastic corsets, skirt 
bands, trouser bands, vests, etc., all or any of which 
held in or compressed its bulging wall — what would 
happen ? Why, something inside would slip out of 
place or burst and let all the wind escape, rele- 
gating our creation to the rubbish heap. 

Now, when a man loses his wind by the rupture 
of a tube, he is said to have expired, and his body 
is sent to the crematory — or ought to be sent there 
for sanitary reasons. It would be much more sat- 
isfactory, by the way, to our friends, after our de- 
mise, were our bodies sterilized while they " live." 

I hope I have made it clear that it is a most seri- 
ous pathological condition — inasmuch as it prevents 
the normal onward progress of ingesta and feces — 
to permit of the continued existence of an exces- 
sively dilated gastro-intestinal canal, with one or 

53 



Intestinal Irrigation 

more of its segments permanently enlarged — seg- 
ments like the stomach, duodenum, caecum, trans- 
verse colon, sigmoid flexure, rectum, etc. — and 
with pendulous abdomen, sallow and muddy com- 
plexion, etc. 

When to this condition is added a general dis- 
placement of the abdominal viscera, or of one or 
more of the organs of the abdominal and pelvic 
cavities, you have an objective picture of chronic 
ill health in all its severity. 

Are you sincerely desirous to know how your 
friends feel when you greet them? Don't ask 
them the stereotyped question, " How do you 
do?" or, if you are a German, " How do you go 
it?" or, if you are a Frenchman, "How do you 
carry yourself ? " But ask them the specific and 
sensible question appropriate to our civilized hab- 
its : "How are you and your bowels to-day ? " And 
at parting it were well to say : " May peace be with 
you both — you and your bowels ! " 

The spirit of man can torment his personality, 
and his personality in turn can vex his spirit. 

Few people are aware of the fact that the stom- 
ach and intestines can undergo alteration in posi- 
tion. Many are familiar with the fact that the kid- 
neys may be displaced, and are then called " float- 
ing kidneys " ; that the liver, pancreas, spleen, and 
uterus occasionally go on excursions, causing there- 
by considerable and numerous disturbances. And 
it is not at all strange that they should, since there 
is so much pressure from within, so much pressure 

54 



Gaseous Obesity and Roly-Polies 

downward, and so much pressure from without — 
all through the requirements of fashion, indul- 
gence, and ignorance. But the stomach, upper por- 
tion of the duodenum, and small intestine, caecum, 
the ascending colon, and especially the transverse 
colon and sigmoid flexure, are susceptible to vari- 
ous forms of displacement, inhibiting the ready 
flow or passage of food stuffs, gases, and feces 
from one segment of the digestive apparatus to 
another, until the vent is reached. 

Reviewing the ground already gone over, we 
have found that proctitis, as a rule, is the primary 
cause of sigmoiditis and colitis ; that these com- 
bined are the cause of constipation ; that this is 
the cause of indigestion, flatulency, and distended 
alimentary canal, and, as matters go from bad to 
worse, of permanent distentions and displacement. 
Is it any wonder then that there are so many that 
suffer from gastro-intestinal neurasthenia f 

Surely our digestive apparatus ought to have as 
much attention as a well-regulated house furnace. 
In the morning the ashes are dumped and fresh 
coal is put on. A similar process is gone through 
with at noon and night. Some may run their fur- 
naces on two meals a day and two dumpings of the 
waste material. 

When a boy puts a penny into a slot machine 
he gets what he expects and is pleased. The ma- 
chine has done its work in delivering the goods. 
Why should he give a thought where his penny 
lodged? In like manner man is always ready to 

55 



Intestinal Irrigation 

put food stuff, and other stuff as well, into the 
upper slot of his machine, for he gets immediately 
satisfaction thereby. But he is like the boy ; he 
does n't care a fig what becomes of the stuff so long 
as it does n't annoy him too much. Eventually the 
machine refuses to work, and seems unable to de- 
liver the goods at the other end ; something has 
become clogged or out of gear. Let me advise 
the reader at least to keep the passage clear by 
dumping the systemic furnace twice or thrice daily 
— using the enema to effect the result. 



56 



CHAPTER VII. 

Irrigation of the Assimilative and Elimina- 
tive Organs. 

THE habits of people in general do not seem so 
bad when one considers the average individu- 
al's limitations as to knowledge and thought. The 
fact is that most people don't know, don't think, 
and hence don't care. Let them read more science, 
think more sensibly, and act more seriously ; then 
their habits will be more satisfactory. 

The alimentary receptacle — the stomach or vat 
in which foods and liquids are received and mixed 
— is habitually converted by many persons into a 
chemical retort for all sorts of drugs and remedies, 
with the view of reaching and relieving the ills of 
the various organs of the body, from dandruff to 
corns. The writer believes that he can give more 
and better reasons for his confidence in the thera- 
peutic value of remedies than most other physicians, 
but he wishes to emphasize here the transcendent 
importance of common sense in their administra- 
tion. Before and above all else, however, what is 
wanted is a clean gastro-intestinal canal ; and his 
claim is that water, properly used, is the best agent 
to effect that cleansing. On a par with this canal 
in importance are the eliminative tissues and organs 

, 57 



Intestinal Irrigation 

of the system : the kidneys, mucous membrane, and 
skin. What therapeutic agent, properly used, is 
better than water? After all the assimilative and 
eliminative organs and tissues have been thoroughly 
rinsed with pure, soft water, then, if it be still neces- 
sary to administer a chemical agent, one may be 
selected that will, with these organs and tissues in 
better condition, work wonders. If you are so 
foolish as to allow yourself to become foul from 
head to foot, cleanse yourself with water before 
resorting to chemical aids. 

Somehow or other the mass of even intelligent 
people, not to speak of the great mass of the igno- 
rant, and I may add even my co-workers in the 
healing art, are not aware of the supreme want and 
worth of water for internal and external therapeu- 
tic purposes ; they do not realize how the stomach, 
the bowels, and the kidneys cry for it in their neg- 
lected and infected condition. 

The stomach serves as a convenient receptacle 
to dump things into after the palate has been enter- 
tained and pleased — and about everything is swal- 
lowed but pure, soft water. As a rule the stomach 
takes very kindly to water. It is, moreover, not so 
piggish as to absorb it all and leave its surface in a 
foul condition, covered with ropy, slimy products 
of imperfect digestion. Immediately after degluti- 
tion of water, the stomach does just what it ought 
to do : its muscles contract and dump the contents 
of the stomach into the duodenum, where the prin- 
cipal act of digestion is accomplished. 

58 



Assimilative and Eliminative Organs 

As its name implies, the stomach (stow-make) is 
a receptacle made for the purpose of storing stuffs 
for nutrition. Here they are mixed and broken up 
somewhat, and then deposited in the second or real 
digestive apparatus — the duodenum. This latter 
organ requires water and organic fluids in liberal 
quantities for its digestive operations. Both organs 
need cleansing after they have finished their work, 
and the digestive and assimilative vessels require 
water, not only to convey the building material to 
their harbors, but also to eliminate effectually the 
worn-out tissues and the residuals of the digestive 
process. 

It has been said that were man to discover heaven 
(a clean and healthy locality) he would at once 
convert it into a hell (a vile and filthy one). Man 
is possessed of an organism of whose constituent 
elements water forms over eighty per cent. The 
alvine discharges ought to contain the same per- 
centage of water, if not more. The mucous mem- 
brane and skin, to be kept clean, soft, fresh, plump, 
moist, and free from odors, require their appropri- 
ate irrigation. Man may keep himself clean, both 
inside and out, by irrigating himself before each 
meal daily. The well-watered and well-washed 
body and brain constitute a heaven on earth for 
the indwelling spirit that needs these for its mani- 
festation. 

It does seem sometimes that man in his ignorance 
gets nothing right except to walk forward instead 
of backward. Even so, most likely he walked on 

59 



Intestinal Irrigation 

all fours for ages, judging from his progress to 
date, before he learned to walk on his hind legs. 
To-day we find him self-poisoned, auto-intoxicated, 
a eastro-intestinal neurasthenic. His bowels are 
filled and stretched with ancient feces and gases, 
and his stomach is burdened with undigested food 
and tenacious mucus. 

The average man's scanty excreta from the 
bowels are dry, hard, lumpy, and foul, exhaling a 
noxious odor ; and these excretions may be passed 
once a day, or once in two or three days, or with 
some persons too often, should diarrhea supervene. 
Two-thirds to three-fourths of the fecal mass is ab- 
sorbed by the system every day ; and this absorp- 
tion is accompanied more or less constantly by 
symptoms of indigestion, biliousness, uric acid, 
and many other distressful conditions. 

His breath and the exhalations of a garbage-can 
are much alike ; in fact they are twins, the only dif- 
ference between the human and metallic receptacles 
being that one is capable of walking and the other 
is not. Both manifest the same conditions. 

His mucous membrane is covered more or less 
with catarrhal discharges, which result in granu- 
lated deposits, especially near the orifices. The 
skin is often sallow, dry, yellow, scaly, flabby. 
The hair is dry, non-oily, with a scaly scalp, and 
often there is a loss or total lack of hair. The 
teeth are decayed, the gums are found to recede, 
and the eyes, muscles, joints, etc., are more or less 
affected by calcareous deposits. 

60 



Assimilative and Eliminative Organs 

Man is seldom or never in a normal physiological 
condition. He is either obese or emaciated and 
lean. Most bodies are anemic and ill-conditioned, 
a prey to several ailments. Of course, civilized 
man uses drugs ; he would not be civilized were he 
not to use on occasion a stimulant, tonic, sedative, 
narcotic, etc., and he has to keep in continual touch 
with a doctor, to take care of him by prescribing 
special diet, fasts, exercise, and what not for his 
numerous bodily infirmities. Generally these pre- 
scriptions are ineffective and leave him physically 
weaker and financially poorer, with the barren con- 
solation that he has really tried everything under 
heaven that the wisest knew or that money could 
buy. Yes, indeed, he tries everything : every- 
thing but water — pure, soft, spring or distilled 
water. He never — like the flirt — " thought of 
such a thing"! Very few " humanals " think 
it worth while to irrigate themselves inside and 
out. 

Victims of semi-ignorance, too, get things most 
abominably mixed. They are often half wrong 
and half right ; hence they never enjoy good, 
sound, robust health and its blessings. Physiologi- 
cally, these people are what old-time pastors used 
to describe as lukewarm — neither hot nor cold, 
neither good nor bad, neither dirty nor clean, 
neither fish nor fowl, neither one thing nor another. 
So we find them also complaining and looking for 
the fountain of health and strength, but not looking 
very anxiously — they are not interested enough in 

61 



Intestinal Irrigation 



HRST TMORA 
CIC VERTEBRA 



the matter. Whenever they possess an equal 
mixture of ignorance and laziness, there is not 

much hope for 
them. 

Note the position 
of the stomach in 
health, and how, by- 
slight muscular ac- 
tion, it can free it- 
self of its contents. 
When dilatation or 
displacement, or 
both, occur, the 
power of rapidly 
expelling its con- 
tents is diminished 
to the extent in 
which the change 
from the normal 
position and size 
takes place. I have 
found that, if there 
is a normal passing 
down of the ingesta 
and also of the 
feces, the stomach 
will perform its 
functions perfectly. 
Fear of " stomach 
trouble " is ground- 

CEsophagus and stomach in their natural 1 ;r ^ f i 

relation to the vertebral column and aorta. iebb u J UU Kee P ine 
(Gerrish.) ^ 



TWELFTH TMORA 
CIC VERTEBRA 




Assimilative and Eliminative Organs 

digestive and eliminative apparatus in good work- 
ing order. But this requires that you must keep 



/ESOPHAGUS 




Fig. 17. 
Stomach and duodenum — the liver and most of the intestines having 
been removed. (Gerrish.) Shows the anatomical relation of the stomach, 
duodenum, kidneys, diaphragm, and the large artery and vein. 

them clean, and to do so you must drink plenty 
of water before each meal. 

The organs are held in position by a ligamentous 
attachment and abundant fatty tissue, which serve 



•^CARDIAC END 



GREATER 
CURVATURB 



Intestinal Irrigation 

as a connective cushion that furnishes aid in sup- 
porting the organs in their proper place. In chronic 
cases of self-poisoning, the victim, as a rule, becomes 
anemic and emaciated, and loses thereby the fatty 
support required by the organs. They are con- 
sequently apt to become displaced and the mus- 
cular tissue weakened, with the consequent pen- 
dulous condition of the abdomen often observed 
in both children and adults. 

The clay-colored, flabby, obese, anemic victims 
may retain their worthless adipose tissue ; but they 
suffer quite as keenly as if they had lost it — from 
the fact that this tissue is impregnated with poison 
and filled with gas, and from the further fact that 
this abnormal tissue presses on the vital organs 
here and there as the victim wheezes or puffs along 
on his road through existence. 

There is not the slightest doubt that nine-tenths 
of gastro-intestinal ills and their effects can be pre- 
vented or cured by thorough irrigation of the canal, 
from mouth to anus, if it does not itself perform 
the cleansing process three times in twenty-four 
hours. 



64 



CHAPTER VIII. 

Methods of Stomach Cleansing. 

LAVAGE is a term restricted to irrigation of the 
stomach — a term that has become more or 
less popular of late with physicians, but is not 
so popular with those who have to swallow a rubber 
stomach tube, or with the anxious mother or friends 
who are usually not permitted to be present on 
such occasions because of the disturbed and cyan- 
otic appearance of the patient — an appearance pro- 
duced by the introduction of the catheter. Much 
can be said, however, of the good results following 
irrigation of the stomach by the employment of 
the stomach rubber tube, and in a special class of 
cases its use is imperative. 

But my purpose in this chapter is to advocate 
the drinking of water as the means par excellence 
for effective irrigation of the assimilative and elimi- 
native organs, and to make it plain that this form 
of irrigation is essential for the preservation of 
health and the relief and cure of chronic inactivity 
of the principal organs of the system. Usually the 
drinking of water at regular intervals is sufficient ; 
but in exceptional cases a generous drinking will 
result in a complete unloading, which can be ac- 

65-5 



Intestinal Irrigation 

complished with ease and with little loss of 
time. 

Should your stomach be actually performing its 
office, the suggestions I am about to give will, if 
followed, keep it sweet, clean, and in good condi- 
tion, and will also flush all the tissues of the body 
as well. 

The first duty on rising in the morning should 
be that of flushing the colon, as previously recom- 
mended, and flushing the stomach, as now recom- 
mended. Take one or two goblets of water (about 
eight ounces each) at a temperature most agree- 
able, which, however, should not be ice cold. An 
hour or half an hour later, during the breakfast, 
take one goblet of milk and water or two of water 
alone, when the mouth is free from food. About 
eleven o'clock in the forenoon, one or two goblets 
of spring or distilled water, at its natural tempera- 
ture, should be drunk to cleanse the stomach, 
duodenum, kidneys, etc., and to flush the tissues of 
the body. At the noon meal one or two goblets, 
and at four or five in the afternoon a similar 
amount, should be drunk — the latter as a cleanser 
before the evening meal, at which about a pint or 
more is drunk to aid in emulsifying the food, as at 
the breakfast and noon repasts. As a rule, besides 
the amounts drunk at meal-time, there should be 
consumed as much as two quarts daily, and the 
best time for this is when the stomach is empty, or 
when it ought to be empty. At bedtime, one or 
more glasses may be drunk if one does not suffer 

66 



Methods of Stomach Cleansing 

from inconvenience from a full bladder during the 
sleeping hours. 

One should make water-drinking a habit, like 
eating, sleeping, defecating, etc. Water-drinking 
should be performed at regular periods during the 
day. System is as essential for the harmonious 
working of the organs as it is for the relations of 
the departments in a business, or of the details of 
any particular department. The guide to the order 
and temperature to be adopted is agreeableness. 
Find out by experiment what is most agreeable 
and beneficial to you, and continue the practice 
with slight variations adapted to the changes of the 
seasons and the conditions of the system. There 
must, however, be some training done in most 
cases, and what is not agreeable at first may be- 
come so. 

All persons suffering from proctitis and colitis 
and their symptoms, as described in the previous 
chapters of this work and in Intestinal Ills, will 
require, now and then, if not under treatment, 
special irrigation of the stomach to remove fermen- 
tative matter, particles of undigested food, and 
tenacious, ropy mucus before the next meal is taken. 
Otherwise the condition will be made doubly bad, 
for the fresh material is piled on top of the unduly 
retained contents of the stomach. As evidence of 
our civilization, we clean pots and kettles before 
the next meal. We even clean our fingers before, 
during, and after the meal. Teeth, mouth, and 
face get their proper cleansing. Why should we 

67 



Intestinal Irrigation 



& 



suppose that stomach, duodenum, and kidneys, 
which receive all sorts of stuff, should remain clean 
without an occasional flushing ? They need rinsing 
out after brewing the wine of life. The water drunk 
between meals not only cleanses the organs through 
which it passes but irrigates the whole system, keep- 
ing a normal amount of water in all the tissues, 
which is as necessary for the maintenance of health 
as is the due supply of water to the plant in your 
conservatory. 

Observe the large percentage of human beings 
that are anemic, sallow, clay-colored, or white — 
a few obese, but the many spare, lean, gaunt — all of 
them expressing the disgust of the soul in having 
such an abiding-place. If all the organs and tis- 
sues of the body were kept flushed, what a fresh 
and inviting spot the soul would have for the culti- 
vation here on earth of the arts of life ! 

Water is the wholesomest of all drinks. It 
quickens the appetite and strengthens the diges- 
tion. It is the most effective agent in the work of 
elimination — in ridding the system of waste mate- 
rial. Properly taken, it prevents the undue clog- 
ging of the organs and tissues, and tends to cure or 
relieve those that had become clogged, and it does 
this by washing away the substances for which the 
system has no further use, and which if they re- 
mained would poison it. 

It is said that if water be drunk freely during 
a meal the gastric juice will become diluted or 
washed away. A similar objection is offered con- 

68 



Methods of Stomach Cleansing 

cerning the use of the enema. The horse, it is 
alleged, should have more sense than to drink from 
three to six gallons of water and almost immedi- 
ately thereafter eat a peck or more of oats and a 
quantity of hay, for it ought to know that there is 
no room for food with such an amount of water in 
the stomach. If such objectors could but see the 
horse smile at such arguments — for it secretly 
knows that the water does not remain in its stom- 
ach, and that its gastric juice is naturally strong 
and needs dilution — they would stand aghast. 
Would we not be better off if we were not influ- 
enced by fool talk like the above advice to the horse, 
especially as regards our internal economy ? 

The stomach, like the freight station, can accom- 
modate only a limited amount. Its contents must 
be rapidly dispersed, and every muscular contrac- 
tion and every respiration gives it an impulse. 
Disease and lack of irrigation will occasion an ac- 
cumulation or congestion of the contents in the 
gastro-intestinal canal, and then the victim of slow 
transit complains of indigestion, biliousness, flatu- 
lency, uric acid, and of many other ills. Your foul, 
furred tongue is a very good indication of the 
trouble below, so it is wise to examine it in the 
morning to learn your interior condition. Many 
persons scrape their tongue with a knife because 
of heavy coating and offensive odor and taste. Dys- 
peptics of this order need a thorough internal bath 
from above (per os) and from below (per anus). 

Some that suffer from undue gastric retention 
6 9 



Intestinal Irrigation 

and indigestion will find relief by flushing the colon 
and the stomach, as herein specifically directed. 
Others may find it desirable to start with a mild 
laxative and an intestinal wash-out with hot water 
in which some antiseptic or stimulant has been dis- 
solved. The special stomach cleansing is accom- 
plished by the rapid drinking of one tumbler of 
hot water after another, until a pint or more is 
taken into the stomach, or until a sensation of 
vomiting is felt, which may be encouraged by put- 
ting the end of the finger down the throat as far as 
possible or the end of a long lead-pencil wrapped 
in a little muslin. After as much of the contents 
of the stomach as is desired is thus cast forth, drink 
freely of water again, as much as you may think 
proper, which will be discharged into the duode- 
num. If this gastro-cleansing has occurred near 
meal-time omit the meal altogether, and in an hour 
or two drink as much water as is agreeable, to 
make sure of a thorough washing out of the erst- 
while neglected receptacle — the stomach. This 
special washing out of the stomach may be re- 
peated as often as occasion demands it. It fre- 
quently happens with some persons that an hour 
after a meal there is a hint that all is not well. This 
may be concealed or corrected by drinking a gob- 
let or two of water, which practice will permit the 
brew to go on without further attention to the vat. 
Water may be taken at all times of the day or 
night if occasion arises for its therapeutic effect in 
addition to its regular period of use. Usually 



Methods of Stomach Cleansing 

physic, pepsin, soda, charcoal, whiskey, etc., are 
kept within reach, and are resorted to on such oc- 
casions with the thought that one or more of them 
will do the work. They will not, however, any more 
than red paint will act as an antidote to poor health by 
painting the cheeks w ith it. Water, hot water, especi- 
ally when used plentifully, is the only solvent of dirt. 

Very few realize how essential water is to diges- 
tion and to the digestive canal after the process of 
digestion is completed ; and that it has physiological 
effects on the system generally is less widely known. 
There exists a great natural demand for water to 
carry on the normal functions of the system ; for 
both atmosphere and heat draw moisture from the 
body, and a considerable amount is utilized in the 
processes of our daily work and in unexpected ef- 
forts. An organism composed of almost eighty per 
cent, of water requires a generous supply for sub- 
sistence — a supply equal to the expenditure of 
vitality involved in carrying on the numerous func- 
tions of body and brain. 

Some day it will be discovered that water is 
mainly the element employed in psycho-physiologi- 
cal processes. Water is easily changed to air, and 
atmospheric air to water, in the system. The 
generous consumer of air and water will have a 
good stock of vital or of psychical force on which 
to draw for the process of thinking. A thinker is 
a creator, and he must be successful if his thoughts 
be rightly directed and he have an ample supply of 
liquid food — water. 

71 



CHAPTER IX. 

When Enemas Should Be Taken. 

METHOD is imperative in this strenuous life of 
ours. Nature in her universal operations 
seems to sanction a uniform system in our daily 
conduct. Had we a regular time for doing things, 
periodicity would be established in our sleeping, 
eating, bathing, defecating, work, recreation, etc. 
Unfortunately, we are prone to ignorance, self-in- 
dulgence, procrastination, which render us careless 
and reckless in regard to the common-sense condi- 
tions of normal living ; and before we are fairly out 
of our 'teens we begin to bear a crop of proctitis, 
colitis, constipation, etc. 

It is in this way that periodicity as to stooling is 
lost, and whim, convenience, or necessity takes its 
place. As a result, we dribble or strain under the 
fecal and gaseous burden. This happy-go-lucky 
method accounts for much of the gastro-intestinal 
disorder complained of by so many, who "want to 
die " when the painful neurasthenic blues hover 
around and pervade their bodies like a dense fog. 

The insidious manner in which proctitis, colitis, 
constipation, and self-poisoning progress from mild 
through medium to severe stages does not, gener- 



72 



When Enemas Should Be Taken 

ally, alarm the victim of intestinal neurasthenia 
until many years have elapsed, and one or more of 
the vital organs have become diseased, and the 
whole system is thoroughly under its toxic effects. 
Thus, slowly, are the various segments of the gastro- 
intestinal canal changed to an abnormal condition. 

Suppose the tissues of one of your arms and 
hands were inflamed, constricted, or swollen, and 
that the nerves of motion were uncertain, shaky, 
and "kinky," — all of which conditions we often 
find in the digestive apparatus, — and that finally 
recovery takes place under persevering and patient 
treatment ; how soon, think you, could a sensible 
person expect the limb thus affected to become as 
useful as its companion that had never been dis- 
turbed by disease ? 

Unfortunately, we have not two sets of bowels. 
Ocean steamers are equipped with two sets of mo- 
tion-producing engines, so that the disability of one 
will result in no loss of speed. When man places 
as much commercial value on himself as he does on 
his machines or on a boat, he will either induce 
Nature to furnish him with an extra set of energy- 
producing organs, or he will take the best possible 
care of the only one she vouchsafes to him — a care 
that extends from os to anus. 

Civilized man does, indeed, take a little notice of 
a sore mouth (although indifferent about an unclean 
one), and will even try hard to have it heal, because 
a sore mouth may be seen, and is likely to disfigure 
him. But a sore anus and rectum may, for all he 

73 



Intestinal Irrigation 

seriously cares, play their painful and poisonous 
pranks until he is put to bed disabled or is sent to 
an asylum — or to the final inn where all diseases of 
the body cease from troubling and the weary organs 
are at rest. 

To re-establish that normal regime of physio- 
logical relations called health, after many years of 
perverse relations and disorderly practices, ob- 
viously requires time and intelligent, faithful 
attention to prescribed conditions. 

The factors or causes that militate against the 
removal of curable diseases are : 

(i) The neglect of a local disorder until it has 
had time to exhaust the general vitality of the 
system. 

(2) Inattention on the part of the patient after 
he has obtained temporary or partial relief. 

(3) The victim arbitrarily setting his own time 
limit for the cure of the disease. 

(4) His wilful disobedience of prescribed rules. 

(5) Inability to realize the importance of having 
the cause removed, as well as the local symptoms. 

Confining attention for the present to proctitis 
and colitis, I wish to impress the patient, as well as 
the physician, with the fact that no better measure 
for relieving or removing these undermining disor- 
ders can be adopted than the regular practice, 
twice or thrice daily, of intestinal irrigation by 
means of enemas. The persistent use of the 
enema is directly influential in relieving and re- 
moving the symptoms of such disorders. These 

74 



When Enemas Should Be Taken 

symptoms may be piles, prolapse, skinny tabs, fis- 
sure, dull pains, soreness, itching channels, stricture 
of the anus and rectum, ulceration, abscess, fistula, 
cancer, etc. 

In the early history of ulcerative proctitis and 
colitis, the local symptoms at the anal vent may 
not be noticeable ; yet the disease may be quite 
well developed for six or nine inches along the 
bowels. The early or more obscure symptoms are 
mild and unnoticeable ; then they progress into 
notice, sometimes most sharply; finally we have 
severe and chronic constipation, indigestion, flatu- 
lency, diarrhea, etc., and, keeping pace with these, 
we have the stages of self-poisoning, which is 
known as auto-infection or auto-intoxication. 

With other measures, the most effective for re- 
lieving and removing these symptoms of proctitis 
and colitis is the enema night and morning. Dur- 
ing the long period of relaxation at night, the func- 
tions of elimination and repair are, with the great 
majority of us, going on under abnormal condi- 
tions — such, for instance, as excessive fermentation 
and bacterial putrefaction, which generate poison- 
ous gases that are absorbed by the nerves and 
bring about the condition of malaise we complain 
of when we rise in the morning. We then find our 
bowels distended and ready for relief — and also, 
strangely, " not ready " ! 

Before dressing, therefore, is the time to relieve 
the excessive pressure from gases and feces, and a 
slight enema is accordingly advisable, say from 

75 



Intestinal Irrigation 

half a pint to a pint of water, which should be ex- 
pelled at once. This removal of the contents of 
the rectum and perhaps of the sigmoid flexure will 
permit the contents of the ascending and transverse 
colon to pass more readily toward and into the sig- 
moid flexure, as though they had been invited to 
come ; and, indeed, such passage is rendered inevi- 
table by the removal of the local gas and feces in 
their path. When half an hour or more has passed 
and breakfast is over, it is time for the regular and 
complete evacuation of the bowels, by the aid of 
the internal bath, or, as some describe it, by a full 
flushing of the colon. 

In our early efforts to establish harmony and 
periodicity with the enema, it is advisable to resort 
to a mild vegetal laxative, in some cases, rather 
than to let the tongue indicate so much foulness 
and allow the feelings to become so intensely blue 
that they cannot be hidden by even the utmost 
effort at pleasantry. Extreme cases may call for 
different aids toward relief, until, one by one, these 
aids may be dropped — the last one to be discon- 
tinued being the enema. 

For a short time at the start it is, perhaps, best 
to confine one's self to two enemas, especially if 
fairly successful with the attempt at a thorough 
cleansing after breakfast and before retiring at 
night. The sleep will be sounder and the patient 
will be more apt to rise refreshed with a clean 
tongue and cheerful spirits. So much will this 
before-bed enema do for him that he may soon 

76 



When Enemas Should Be Taken 

find it unnecessary to take the preliminary injec- 
tion on rising, inasmuch as fermentation and gas 
will no longer trouble him. But individual experi- 
ence and intelligence must dictate the course in 
this respect. Let the patient study himself and 
note the demands of his system. It may even be, 
indeed it is frequently the case, that a patient re- 
quires several enemas during the day. When ab- 
normality has set in, it gives rise to all sorts of 
freak requirements, and the victim must, for a 
time, accede to its whims. 

Quite frequently, owing to various causes, the 
feces will descend into the rectum, which is prop- 
erly a conduit, not a receptacle. While there it 
occasions much nervous irritation of the whole 
system and makes its victim desperate. It is wise, 
under such a condition, to take slight injections for 
relief. Never allow any foulness to accumulate. 
Establish the habit of internal cleanliness. The 
new sense of bodily purity will be so great that it 
can never be outgrown. 

Nature easily accommodates herself to habits, 
whatever they be — normal or abnormal, wholesome 
or unwholesome, cleanly or uncleanly ; and the 
train of consequences will be accordingly good or 
evil. My point may be easily illustrated by the 
habits of " civilized " man in regard to bathing. 
Many persons never take an external bath, and 
are not conscious of any bodily discomfort arising 
from the omission of this presumably necessary 
practice. As the summer approaches, another batch 

77 



Intestinal Irrigation 

of " civilizees," so fortunate as to be within conven- 
ient distance of a pond, lake, river, or ocean, begin 
to feel the real need of a ''dip," and are uncom- 
fortable until they get it. This is surely a sign 
that the spirit of cleanliness is beginning to stir in 
the breast of humanity. Then there is another 
contingent that bathe once a week, and should 
their regular routine in this respect be interfered 
with they would at once feel unclean — nay, even 
dirty, and. sometimes, "nasty." Others, again, 
bathe twice or thrice weekly, and this quota of 
the human race feels very uncomfortable and foul 
when hindered for a week from following this rou- 
tine ; indeed, such bathers often imagine that a dire 
illness is impending. Finallv. the "salt of the 
earth" take an external bath once or twice a day, 
and, should their routine be suspended for twenty- 
four hours, visions of madness or suicide beein to 
haunt them until relieved by soap and hot water, 
or the cold plunge, as their habits require. 

Of course, the same rule applies to the routine 
concerning the teeth, facial ablutions, etc. Nature 
is stored habit, and she feels outraged when her 
proprieties are disregarded. Let us pray, there- 
fore, that the habit of cleanliness may become 
contagious ! 

Xow, the parallel between external and internal 
cleanliness is quite obvious. Those whose bowels 
move but once in two or three days do not realize 
how foul they are. Others have a scant evacua- 
tion once in twenty-lour hours, and they imagine 



When Enemas Should Be Taken 

that they are as clean as those that take an ex- 
ternal bath once a week think themselves to be. 
Still others have two stools daily, and they feel as 
clean internally as those that take three external 
baths weekly. And, finally, there are a few who, 
defecating thrice daily, feel quite as clean as does 
the most persistent external bather. Thus we see 
that cleanliness, external and internal, is a habit, a 
new nature, attended with exquisite comfort and 
pleasure — a quality that may lead to the goal of 
divine purity in realizing the joys of hydropathy. 

The wild woodland flower grew and blossomed 
without attention, attracting but little interest. 
After, however, the florist has cultivated it to the 
high stage of development in which we find it to- 
day, with its stalk, stem, leaf, and fragrant petals 
displaying their marvelous symmetry and beauty, 
we begin to appreciate the value of labor, pains, 
cultivation. In like manner, it is our imperative 
duty to give proper care to every requisite detail 
in the transformation of our body into a human 
flower of health, grace, joy, and harmony. 

The great majority of those that do me the 
honor to read what I have to say on internal and 
external cleanliness will, doubtless, not agree with 
me as to the frequency of the ablutions in twenty- 
four hours. Yet I have a suspicion that if my ob- 
jectors were to try an external and an internal bath, 
on both rising and retiring, they would soon con- 
sider the practice too delightful to be foregone ; 
they would soon develop more sweetness of char- 

79 



Intestinal. Irrigation 

acter and be more particular as to the purity of 
their nether garments, and, finally, would seem 
ensphered by an atmosphere peopled with angels. 

My proposition is this : First make a man clean, 
internally and externally, and thus you may make 
him good ; after you have made him good you can 
make him healthy in both body and mind ; after you 
have made him healthy you can make him full of 
joy. 

To recapitulate : A good time to take your in- 
ternal bath is about half an hour after each meal. 
Cultivate regularity in this, and Nature will second 
your efforts and establish a periodicity for you 
by her suggestive impulse and call. Our internal 
economy should not be slighted as it has been. 
The intestines are good, faithful, patient servitors, 
ready to perform their lowly office even when we 
are inattentive and heedless. Sometimes, how- 
ever, they become rebellious, after they have stood 
more abuse than one would think them capable of 
standing. Let us reform our bad habits ; our servi- 
tors are willing to enter with us into better habits, 
and co-operate with us in a truly human life. Can 
you not spare a few minutes, three times a day, at 
regular periods, for inner purification ? You will 
find it very easy when once you make it a matter 
of routine. 

Now note this point : The work of your brain 
depends on the power sent to it by the gastro- 
intestinal canal. A motor car goes no faster than 
the power furnished enables it to go. So your 

80 



When Enemas Should Be Taken 

brain activity is ever on a par with the energy sup- 
plied from this usually despised intestinal source ; 
that is, it can never rise higher than the supply of 
this energy warrants, and it always falls to the 
level of this supply, for it depends on it absolutely 
for sustaining power. It would seem, therefore, 
that common sense would be sufficient to shame 
us into keeping clean, scrupulously clean, the canal 
that supplies us with working force — the canal that 
extends without a break from mouth to anus. Yet 
my experience shows that almost everybody cares 
more for his outsides than for his insides — more 
for squandering his stored energy than for looking 
out for its constant renewal — and that most patients 
are foul all the way down. 

Well-fed animals that have the range of Nature 
are plump, and have healthy hair, skin, teeth, etc., 
because their intestinal organs perform their func- 
tions frequently and fully. When animals become 
domesticated and " civilized," they become con- 
stipated and catch various human illnesses or grow 
a crop of their own. Well-fed " humanals " grow 
thin and puny, or bloated with gas, looking like 
corpulent clay men, without natural teeth, without 
natural hair, their skin dry and of a sickly hue, 
bloodless, fading away because of an early blight 
before they have completed their early growth. 
Heredity is blamed for the bloodless, nerveless, 
brainless body, when, as a matter of fact, its de- 
generation is due to foulness within. 

Birds, beasts, and savages (more fortunate than 

81 



Intestinal Irrigation 

civilized man) have the wide earth on which to 
stool when Nature calls. Their handy water-closet 
enables them to enjoy good health. As civilization 
advances, and business and social customs become 
more complex, water-closets get fewer and less ac- 
cessible. As a consequence, man has to use his 
large intestine for a storehouse. He has done this 
so long that it seems impossible to break him of 
the foul habit But he is paying the penalty. 
Many have abused the bladder in the same way, 
and had this been a large organ like its brother, 
the colon, we would long ago have heard the stereo- 
typed excuse in regard to this function, " Oh, any 
time to urinate that I can find will do." Those 
who object to the new order of bowel relief should, 
on the same principle, object to frequent bladder 
relief. 

I submit this proposition to the judgment of un- 
prejudiced minds : Is it not reasonable that so 
harmless and efficient a remedy as the internal 
bath should be adopted by all intelligent persons ? 
Inasmuch as neglect — due to social, business, and 
other customs, and to lack of conveniences for 
ready relief — has brought upon us so much fecal 
poisoning and local disorders and so many abnor- 
mal and pernicious systemic results, it should not 
be considered too great a task to take an internal 
bath three times a day to amend our outrage on 
Nature — an outrage that involves our health and 
general well-being, here and hereafter. We owe 
it, not only to our possibilities, but also to poster- 

82 



When Enemas Should Be Taken 

ity, that fecal poisoning be banished. We have no 
right to communicate such a taint to our children. 
They have a right to be free from such poison. 
Do we ever think of their claims in this regard ? 
Let us leave them a better legacy, by adopting the 
thrice-a-day use of the enema for the purification 
of the alimentary canal ! 



83 



CHAPTER X. 
How Enemas Should Be Taken. 

METHODS OF INTESTINAL IRRIGATION. 

A SATISFACTORY appliance for taking an 
enema should possess the following features : 
capacity, adaptability, convenience, cleanliness, du- 
rability, and sufficient external anal and water 
pressure to effect a thorough flushing or an agree- 
able vaginal injection while one is in a sitting 
position over a water-closet bowl. 

There are several postures in which an enema 
may be taken. For those physically able, the most 
convenient, cleanly, and comfortable manner in 
which the thrice-daily inner bath may be had is the 
usual upright position on a water-closet seat. For 
those not physically able to sit upright, or for those 
that are not up-to-date and still adhere to the use 
of the fountain or the bulb syringe, the best method 
is not the usual sitting position, but the recumbent 
one. They are advised to lie on the right side, or 
on the back with hips raised. As a rule, a water- 
closet room is too small for reclining purposes, and, 
besides, the necessary rubber sheet and toweling 
convenience may be absent. Another drawback to 

84 



How Enemas Should Be Taken 

lying full length for the purpose of flushing the 
colon is that with short arms and the lack of exter- 
nal anal pressure there is apt to be an escape of 
water and feces around the anal point, necessitating 
much cleansing, considerable annoyance from nasty 
odors, and an irritating waste of time. 

Various devices, advertised as great inventions, 
have been resorted to for the purpose of over- 
coming such malodorous and uncleanly incidents. 
Among them is one that may be described as a 
colon tube, ranging from nine to eighteen inches in 
length, which can be attached to a fountain or a 
bulb syringe. The tube is usually of flexible rubber, 
colored red to hide as much as possible the cumula- 
tive evidence of saturated filth and bacterial poison, 
the presence of which a white tube would betray 
too readily. 

I fail to see the necessity of introducing a rubber 
canal of such length into an intestinal channel five 
feet long for the purpose of ''cleansing" the latter. 
The project lacks common sense. What a ridicu- 
lous practice — to worm or bore a hole through the 
impacted feces as you work your tube upward, then 
to squirt a little water into the middle of things, 
or as near to the middle as you have managed to 
get with a tube that will persist in bending on it- 
self, and then to withdraw it covered with liquid 
filth ! What folly to put a canal into a canal — the 
one inserted being one-fifth the length of the one 
to be cleansed ! Is not the original physiological 
channel good enough to convey the antiseptic water 

85 



Intestinal Irrigation 

or oil, or both ? Why not have the rubber canal 
five or six feet long if one foot is so essential ? 

We should remember that ulcerative proctitis and 
colitis have made the use of the enema a necessity ; 
that, accordingly, the diseased, constricted gut or 
canal must be treated very gently and not irritated 
in any avoidable way. The least irritation will re- 
sult in still greater muscular contraction. It stands 
to reason that the effort to reach the healthy por- 
tion of the bowel with a slightly flexible colon tube 
frustrates its own purpose, and that it is besides a 
source of serious and unnecessary irritation. While 
this rubber tube is being forced up one's bowels it 
often becomes lodged here and there in the valves 
and folds of the mucous membrane. It has been 
found that the effort used to dislodge it sometimes 
results in a doubling of the tube on itself in the 
form of a knot, and that the end first introduced 
comes back to the anus waiting to escape with the 
next push ! We need not argue that this forced 
looping and knotting of the tube is very injurious 
to the diseased intestinal region, and that no one 
would care to introduce it two or three times a 
day. 

Does not common sense suggest that the rational 
way is to open the bore of the alimentary canal by 
beginning at its end ; that liquid should be applied 
directly to the first feces encountered, and that as 
this impacted mass is removed the progress should 
be successfully upward ? The liquid as it enters 
dilates the channel, and as it passes on and up it 

86 



How Enemas Should Be Taken 

eventually gets beyond the diseased section of the 
bowels. Here, by a gentle and soothing dilatation, 
we create at once an impulse in the imprisoned 
feces and gases to descend and escape. What 
other method is so kindly, and yet so effectual ? 
We avoid, by this means, irritating the diseased 
and constricted muscular canal ; whereas by the 
tube method we occasion still greater contraction, 
the inflamed surface having a tendency to contract 
and close tightly over the tube. The flood of 
liquid dilates the canal ; whereas the forced rubber 
tube, by irritation, contracts it. Besides, as has 
been pointed out, the conduct of the tube working 
in the dark is most uncertain. 

Suppose the rubber tube does finally reach the 
section of the colon free from inflammation ; that 
its passage thither has greatly increased the spas- 
modic contraction of the diseased portion of the 
gut, and that, of course, it had great difficulty in 
circumventing the resistance offered by the valves, 
curves, and short bends — suppose all this, and an 
idea of how the contents of the bowel above the 
diseased zone are imprisoned will dawn upon you. 
For, after the tube has reached this point of im- 
paction, the distention there is most unduly in- 
creased by the sudden gush of water, and, what is 
of still graver import, the presence of the tube 
prevents its return flow. Then as the object is 
being removed the watery feces following closely 
after are impeded by the increased irritative contrac- 
tion set up by the tube. 
87 



Intestinal Irrigation 

In short, this greatly extolled colon tube subjects 
the region of proctitis and colitis, as well as the 
healthy section, to just such objectionable pro- 
cedure until the amount of water injected becomes 
so extremely large that a means of escape is irre- 
sistibly produced by the great pressure above. Is 
it wise treatment to irritate the diseased portion 
of the bowels, and to distend still further the 
healthy portion above, in order to get rid of dis- 
tention due to feces and gases ? Without increas- 
ing the danger by injecting water into the already 
unduly distended colon by the use of the tube, the 
imprisoned feces and gases of themselves alone 
have been known to exert sufficient pressure to 
occasion prolapse of the sigmoid flexure into 
the rectum or undue displacement of the organ. 
Surely it were better to get rid of the imprisoned 
contents by removing them from near the vent and 
working one's way gradually upward than to add 
more to the store and burden, which only causes 
unendurable excitement and fierce demands for 
relief. 

The rectal enema, taken in the rational way, 
simply dilates the portion of the gut that is mor- 
bidly contracted — a procedure that is very bene- 
ficial and should be continued just so long as any 
remnant of the inflammation remains in the tissues. 
Kindly treatment is essential, because ulcerative 
inflammation is an irritable condition and tends to 
contract the muscular tissue at the slightest touch 
of a foreign substance. What, I repeat, is more 

8S 



How Enemas Should Be Taken 

kind and soothing than antiseptic water mixed with 
oil? 

Advocates of the colon tube assert that water 
entering the lower portion of the rectum will occa- 
sion ballooning of this portion of the gut. After 
an experience covering twenty or more years, I am 
in a position to say that there is absolutely nothing 
in this objection — that water used in this way can- 
not produce such a pathological condition. Bal- 
looning of the lower portion of the rectum is 
occasioned by impaction of feces, which remain 
lodeed often for weeks or months at a time in this 
locality. Whatever dilatation the use of the enema 
may transiently produce would be only healthy 
exercise for the diseased organ. An instrument is 
frequently used properly to dilate the more or less 
contracted canal above and below the distended 
pouch for a distance of from six to ten or more 
inches. Nothing but good results can follow the 
proper use of the enema two or three times a day 
in all forms of local disease of the anus, rectum, and 
colon. 



8 9 



CHAPTER XL 
The Internal Fountain Bath. 
the author's unique invention. 

THE author has searched the markets of the 
world for suitable apparatus for intestinal irri- 
gation, so that he, as a specialist in this line and in 
anal and rectal diseases, could recommend it to his 
patients. None of the appliances to be had, how- 
ever, quite answered the purpose he had in view. 
All of them had some drawbacks. Owing to this 
fact, after much experimentation he has invented an 
instrument that is herein fully described to show 
its serviceableness. Were this volume to be issued 
without this description, the author would be in- 
undated with interrogatories concerning the best 
instrument to be employed by its readers, or 
whether the appliances they have on hand would 
answer the purpose. As the object of this book is 
practical, not literary, it is not out of place, the au- 
thor thinks, to describe the invention and its unique 
serviceableness, as well as its special adaptability for 
the tri-daily employment of enemas. 

The instrument is known as " The Internal Foun- 
tain Bath for Home Treatment." The following 

90 



The Internal Fountain Bath 

illustration gives a very good idea of its construc- 
tion and merits : 



FIG ^18 




[Patented Dec. 31, 1901 ; Nov. 14, 1905.] 

Figures 18, 21, 22, and 23. 



18, Reservoir; 21, hard rubber handle; 22, metal handle; 23, metal 
handle, hard rubber cone, and enema point ; 19, lamp support ; 2 , lamp ; 
33, rubber tube and shut-off ; 24, glass bottle; 27, hard rubber anal cone; 
29. valve ; 28, enema point ; 25 and 26, recurrent douche points ; 30, glass 
bottle ; 31, hard rubber cone ; 32, enema point. 

Figure 24, Page 120, illustrates the author's rubber enema appliance, The 
Niagara Fountain Syringe, holding about two gallons of water. 



The Internal and External Fountain Bath is an 
appliance that I have devised and supplied to my 
patients for many years with most satisfactory 

91 



Intestinal Irrigation 

results in every particular. Several other enemata 
and recurrent douche instruments which I have 
used did not wholly meet the requirements in 
capacity or aseptic features ; but long use of this 
apparatus in all the various bowel troubles has 
demonstrated, to me as well as to my students and 
patients, that the instrument is the best that can 
be made, perfectly meeting all the requirements 
essential for scientific results. 

Features and Uses. 

The Fountain Bath is the product of necessity, 
effort, and long experience in accomplishing a de- 
finite purpose fully and properly. Figure 18 illus- 
trates a large enamelled metal reservoir for water. 
Figure 21 shows a hard rubber combined enema 
and recurrent douche appliance for the application 
of water to the mucous membrane of the large in- 
testine, the temperature of which should range from 
ninety to one hundred and thirty-five degrees or 
more. To one end of the handle is attached a hard 
rubber anal cone (Figure 27), inside of which is a 
valve (Figure 29), which is opened and closed by 
turning the handle, permitting the water to pass 
through the rectal point (Figure 25), or (Figure 26) 
into the bowels and return into the toilet basin 
without removing the point. At the other end of 
the handle is attached a glass reservoir for the use 
of oils. Figure 22 is a metal handle with a glass 
reservoir and a hard rubber anal cone. Figure 2 » 

92 



The Internal Fountain Bath 

is a metal handle without glass reservoir, and both 
are intended for the use of water at a temperature 
of from ninety to one hundred and five or one 
hundred and ten degrees. A thermometer is ab- 
solutely necessary to determine the temperature of 
the water during its use as a depurent and anti- 
phlogistic remedy. The heating appliance will keep 
the water at a desired temperature during its 
application, which is a very essential feature indeed. 

Water Capacity. 

The Fountain Bath reservoir holds three gallons 
of water, which is quite sufficient to meet all require- 
ments of the various complicated cases of bowel 
and uterine troubles which require a generous 
supply of tepid or very hot water. This obviates 
any interruption in the use of the enema or the 
recurrent douche treatment until one or both are 
satisfactorily completed, and without changing one's 
position on the toilet seat. It requires a quantity 
of water to irrigate the large intestine, which is 
some five feet long and two and a half inches in 
diameter. It is foolish to attempt to irrigate one 
end of a long, tortuous, foul sewer with one or 
two quarts of water and hope for good results. 
Water is cheap, then why not clean out and keep 
clean ? 

Adaptability. 

For the first time in the history of enemata ap- 
pliances can an enema, recurrent douche, or vaginal 

93 



Intestinal Irrigation 

injection be taken with water at any desired tem- 
perature and at the same time be medicated with 
any remedy desired. External pressure against the 
anal orifice is regulated at will ; also the flushing of 
the integument about the anus and buttocks is 
easily accomplished before leaving the toilet seat. 

Convenience, 



This scientific device can be used without assist- 
ance. It has one feature moreover, that renders 
it unique among rectal appliances, namely that you 
may take a number of rapid injections without 
changing your seat. You may inject a small quan- 
tity of water (from eight to twelve ounces), and 
expel it immediately ; then you may follow with a 
larger amount (from one to three pints), and expel 
that also, then in the same manner flush the colon. 
A complete internal bath may be effected in the 
same way by using three, four or more quarts of 
water. In this way, thorough depurating results 
may be obtained. The several preliminary injec- 
tions of gradually increasing quantities of water 
free the lower bowel of feces, germs, and gases 
which otherwise might be forced by the flushing 
process backward into and along the colon. With 
the Internal Fountain Bath, unlike other syringes, 
it is not inconvenient to take preliminary injections 
before flushing the bowels. After the flushing the 
rectal and anal canals the bowels can be easily 
cleaned their entire length, as can also the integu- 

94 



The Internal Fountain Bath 

ment about the anus and buttocks by letting the 
jet of water play on these parts to wash away any 
germs and other poisonous discharges. All the 
necessary movements of the anal point are easily 
made with the handle which projects between the 
limbs in front of the toilet seat. 

Cleanliness, 

The water reservoir is enameled white, both 
inside and out and free from poisonous substances. 
The enamel is not injured by the use of any ger- 
micidal remedies that may be placed in the water, or 
by the water being brought to a very high tem- 
perature to destroy bacterial poisons. Further- 
more this enameled surface is easily cleaned, thus 
avoiding foulness of the reservoir from continued 
use. The glass medicine case and anal cone at- 
tached to the handle, as well as the anal point, are 
all detachable and easily cleaned, and the handle 
is of sufficient length to obviate soiling the hands 
and impregnating them with odors. 

To bring away a quantity of feces does not ex- 
haust the purpose of the enema. The intestinal 
sewer requires further cleaning from end to end, 
and the external parts around the anus as well. 
By playing a jet of water on the external anal 
region you finish the enema and avoid the very 
uncleanly practice of using " toilet paper" as a 
means of external cleansing. It is strange that 
otherwise cleanly people are content with such 

95 



Intestinal Irrigation 

uncleanly treatment of these parts. They im- 
agine that ''toilet paper" will effectually remove 
the excrement and its attending odors. They 
would not think it sufficient thus to clean their 
hands if soiled by excrementitious matter. It is 
the old story, "out of sight, out of mind," and of 
letting any make-shift in such cases answer ; but 
the spirit of cleanliness is abroad in the land, and 
the Silent Club of the Cleanly is being formed 
through just such agencies as the Internal Fountain 
Bath. Many have doubtless longed for a better 
practice but did not know what to do. The " toilet 
paper" habit will pass with the once-a-day habit of 
stooling, the constipation habit, and the physic 
habit, for all four are uncleanly in the extreme. 

Durability. 

The enameled metal reservoir and the metal and 
hard-rubber parts of the handle ought, with care, 
to last a lifetime ; the soft-rubber tube, if properly 
cared for, will be of service for a long time. 

External Anal Pressure. 

This is of very important assistance in flushing 
the colon, as it aids in preventing the return of the 
injected water, and thereby promotes its convey- 
ance along the colon until it arrives at the surgically 
famous vermiform appendix. It is not strange that 
both ends of the large intestine — the anus and 

9 6 



The Internal Fountain Bath 

rectum and the appendix region — have kept the 
surgeons busy, and I may add the undertaker like- 
wise. These two ends are of extraordinary concern, 
because they manifest intense symptoms and patho- 
logical consequences. Modern medical practice is 
the heroic treatment of symptoms and consequences 
and not patient search for causes of disease and 
sensible treatment of it, as explained in my treatise 
dealing with " Intestinal Ills," as well as in the 
present volume. 

Water Pressure. 

Two or three gallons of water, suspended at the 
usual height of enemata appliance, affords quite 
enough pressure, especially when the outlet and 
tubing are amply large. The shut-off on the rubber 
tube enables the user to gauge the flow of water to 
a nicety. 

Time Required. 

The time required for taking an internal bath — 
that is, for a complete flushing of the bowels — will 
vary in individual cases. After removing the local 
deposits in and near the rectum by one or two rapid 
injections of very small quantities of water, two to 
four quarts are taken into the intestinal canal at 
one time, and this constitutes the enema proper. 
Now, many persons will find it advantageous to let 
the flushing water enter very slowly, taking from 

97- 7 



Intestinal Irrigation 

two to five minutes, or even more. With some, if 
the water is allowed to flow in very rapidly, the 
various segments of the rectum and colon may not 
readily accommodate themselves to the inflow, and 
will too soon make an expulsive effort, returning 
the water before it has dissolved the feces or united 
with them, thus defeating the object sought through 
the enema. With other persons, however, the flow 
may be as rapid as desired. The speed must be 
left to individual judgment and experience. 

Temperature of Water for an Enema. 

The chief purpose of an enema is to produce 
depuratory results ; that is, to remove morbid mat- 
ter from the bowels and then to cleanse them. To 
accomplish this effectively and at the same time to 
avoid exciting an increased flow of blood to the 
diseased gut, the water should be about the normal 
temperature of the body, which is about 98-J- de- 
grees. Water too hot or too cold will aggravate 
the sensitive, inflamed surface ; and, as it is this 
very inflammation that causes the abnormal action 
of the bowels for the relief of which the enema is 
taken, the temperature of the water is most import- 
ant. If it range between 90 and 105 degrees it will 
do, for within those extremes it will not be likely to 
increase the existing chronic engorgement of the 
tissues. Under no circumstances should very hot 
or very cold water be used for the removal of fecal 
accumulation. Physicians s>0 incompetent as to 

.99 



The Internal Fountain Bath 

make a wrong diagnosis of the cause of chronic 
constipation and its numerous symptoms often 
prescribe a wrong treatment in the use of water. 
From two to ten minutes' use of very hot or very 
cold water in cases of proctitis and colitis will only 
increase the chronic engorgement of the blood-ves- 
sels and tissues and increase the morbid symptoms. 
When water is applied to the mucous membrane 
anywhere throughout the body, I use it hot exclu- 
sively, as that temperature has then certain advan- 
tages over cold. In the chapters treating upon 
the different uses of hot water, I give the hydro- 
therapeutic action of such liquid on the tissues of 
the body. 

Quantity of Water to be Used. 

The quantity of water to be injected into the 
colon at one time must vary in each case and also 
on each occasion. In the beginning of its use and 
for some time following, a greater amount may be 
required than will be necessary when, with its con- 
tinued use, a better action of the bowels becomes 
established. 

In cases of chronic constipation and semi-consti- 
pation, the kidneys, lungs, mucous membrane, and 
skin eliminate a daily accumulation of feces from 
the system equal to two-thirds or three-fourths of 
the amount of normal feces. This accounts for the 
frequency of chronic disease of these organs. To 
establish a new regime in the mode of fecal and 
gaseous elimination requires much time and pa- 

99 



Intestinal Irrigation 

tience in the use of the enema. Nearly all persons 
can take the enema with comfort and satisfaction. 
Now and then, however, there is a person who finds 
it a little troublesome to inject over a quart of water 
at one time, while most persons can inject over four 
quarts without inconvenience. I would advise pa- 
tience and perseverance on the part of those who 
find it irksome to inject a sufficient amount thor- 
oughly to cleanse the colon, or the portion thereof 
involved in undue accumulation. 

Enough water should be injected to bring away 
what would constitute the normal amount of feces 
to be passed at a regular stool. Gradually, as the 
practice is established by the use of the enema 
twice or thrice daily, it will be easy to determine 
the proper amount of feces to pass. And note this 
fact : it is just as easy to establish the habit of 
three evacuations in twenty-four hours as of two 
or one. 

Whenever the amount of water injected proves 
sufficient at any time to bring away all the feces 
that should pass, it is not necessary at that sitting 
to repeat the dose, except it be for subsequent 
cleansing, as a sort of gargle. No possible harm 
can come from the generous use of the enema 
during a lifetime ; indeed, its constant use will 
prolong life and make it more comfortable. 



IOO 



CHAPTER XII. 

Benefits of the Inner Bath. 

I SPEAK from clinical observation with the use 
of various rectal and colon specula, of which I 
have over fifty. I have watched the progress of 
cases that were using the enema twice or thrice 
daily, and of cases that were also using the intesti- 
nal recurrent douche, which latter required an 
hour's continuous application of hot water, and I 
know, therefore, whereof I speak when I affirm its 
salutary effect both on the local organs and on the 
general system. 

Many that write about the use or abuse of the 
enema have never seen the mucous membrane of 
the rectum and colon. Most of what is written on 
the subject is worthless. The author of this book 
writes from the accumulated experience of daily ex- 
aminations with specula for a period of over twenty- 
three years. Had he merely used his fingers or hand 
for making rectal examinations, or had he contented 
himself with prescribing for symptoms reported by 
the sufferer, his views and opinions as to the use 
and benefits of the internal bath would have been 
on a par with those that, by the old methods, make 
futile efforts in diagnosis and treatment. 



Intestinal Irrigation 

Some good souls now and then become over- 
solicitous as to the matter they should pass when 
their bowels are already empty, and they feel 
alarmed if the enema fails to produce an evacua- 
tion. Such timid ones should remember that what 
they cannot accomplish at one time and with one 
attempt they may at the next, and that thus slowly 
the new order of fecal elimination will become 
established. It takes time and patience ; but is 
this cause for apprehension when diagnosis, treat- 
ment, and means of relief are right ? I claim that 
flushing of the colon is the best means for removal 
of the consequences of proctitis and colitis, and 
that it should be employed by all that have these 
chronic ailments. Let them get relief for the 
symptoms at once and in this rational way, after 
which let them seek scientific treatment for the ail- 
ments themselves ; for, sooner or later, they will 
be compelled to seek it by the severe complications 
that will inevitably set in. 

TRY SCIENTIFIC AND PRACTICAL MEASURES. 

Some persons find difficulty in estimating — or 
think they do, which in most cases is nearer the 
truth — the amount of water they can inject at one 
time, when it would work a great relief to their 
bowels were they able to inject from two to four 
quarts. It is half the battle to know your efforts 
are rightly directed ; for, when you are defeated, 
you will try a thousand and one changes — an ex- 



Benefits of the Inner Bath 

periment first with one element of the difficulty and 
then with another. You will experiment with the 
temperature, with the speed of flow into the rectum 
and colon, with intermittent flow, etc. Be a little 
scientific and original in this matter, I pray you, 
and know no defeat! 

As to the intermittent How, the following way 
may be found judicious in some cases : Take in 
just sufficient water — a few ounces perhaps — to 
provoke an evacuation, and proceed till you have 
taken half a dozen or more. After this you can 
take a greater quantity for a washout. But this is 
not exactly what is meant by the term " intermit- 
tent flow." It means that you may make the ex- 
periment — if you find it difficult to fill up after 
ridding yourself of the local accumulation — of 
turning off the stop-cock for a moment, thus giving 
your bowels a slight rest, and then turning it on 
again, alternating in this way for some minutes. 
Many little devices of similar utility will suggest 
themselves to those who know no defeat. Remem- 
ber that, now that you are in serious trouble, it is 
not the easiest thing in the world to get out of 
it. 

Should your stomach raise objections to the 
enema, change the time. If abdominal pains are 
severe, change the temperature of the water and 
the time and manner of injecting it. In other 
words, do something different, but be determined 
to conquer and take the internal bath at proper 
periods every day. 
103 



Intestinal Irrigation 

LIBERATING THE WATER. 

Some persons who find no trouble at all in taking 
a large quantity of water have much difficulty in 
expelling it, or rather in expelling all of it at once. 
Various methods may be resorted to to liberate 
the retained water. One is to inject a little more, 
as a provoker, when all will escape without further 
difficulty. Another method is to resort to various 
motions of the arms and body. Some find relief 
by raising and projecting both arms together slowly, 
and then stretching and holding them aloft for a 
few moments. Other methods are : to twist the 
trunk a few times, to walk up and down a little, to 
bend forward and backward, etc. Still another 
method is to massage the abdominal walls, begin- 
ning at the ascending colon (see Fig. 12), passing 
upward to the left along the transverse colon, and 
then downward until the lower portion of the sig- 
moid flexure is reached. When beginning- the 
massage, one should use stroking movements from 
right to left over the entire surface, and then go 
over it again with rotary strokes. Some may find 
it advantageous to knead the abdominal muscles, 
gradually reaching the deeper parts as the air is ex- 
pelled from the lungs, which expulsion may change 
the position of the various segments of the in- 
testine and thus afford an opportunity for the feces, 
gases, and water to escape. Before rising in the 
morning and retiring at night, it will be found ad- 
vantageous by some persons to spend about ten 

104 



Benefits of the Inner Bath 

minutes in making the three kinds of manipula- 
tions described. It is an excellent practice for 
every one to lie flat on the chest and abdomen and 
draw in several deep breaths just before rising. 
This exercise will strengthen the muscles of those 
parts and benefit the internal organs as well. 

THE ENEMA AS A PERMANENT PRACTICE. 

In the effort to restore the long-abused bowel to 
its normal functioning by the use of the enema and 
massage, there may be, in the beginning of such 
treatment, an exceptional case in which a mild laxa- 
tive is indicated as the desirable thing, rather than 
that a furred tongue and base bodily feelings shall 
evidence too much foulness all the way up to the 
mouth. 

The enema, of course, constitutes the chief means 
and mainstay of relief from obstipation of the bow- 
els, and one by one the other aids are to be omitted. 
Moreover, when the time comes that the bowel is 
freed from the disease that occasioned the occlu- 
sion and obstipation, — that is to say, when the bow- 
els evacuate themselves naturally three times a day, 
— then the enema itself may be omitted, or it may 
be continued without harm by those whose sense 
of cleanliness would induce them to keep up the 
practice in preference to the uncleanly habit of 
using toilet paper as a partial means toward clean- 
liness. Surely there is no harm in substituting 
a better habit for a worse one — one, moreover, that 
105 



Intestinal Irrigation 

we should be ashamed to continue ! As no one 
would think of cleaning his soiled fingers with 
toilet paper, as already said, so no one with any 
real sense of decency will continue the attempt to 
clean his anal orifice with such material when he 
has learned a better and more effective way. Like- 
wise, after having learned the rational mode of re- 
lieving the surcharged bowels, no wise person will 
continue the use of physic, coarse food, gymnastic 
exercises, and other futile and foolish practices as 
remedial measures for intestinal ailments. 

No one suffering from proctitis and colitis can 
have a clean and healthy sigmoid flexure and rec- 
tum unless these be kept clean by the regular use, 
three times a day, of the enema. From the day 
when the disease invades these parts there is and 
will continue to be a clogged, plastered, or incrusted 
passage for more or less of the entire length of the 
colon. This must be so in the nature of things, 
since these organs are unable to perforin their func- 
tions while the disease is present. Just think of 
possessing a filthy, congested intestinal canal, with- 
out one day of real cleanliness for twenty, forty, 
sixty, or more years ! It is not the easiest thing in 
the world to cleanse this channel even by the use 
of the enema ; for the ancient contents refuse dis- 
lodgment even after repeated flushings, and it is 
only after many days of persistent and patient irri- 
gation that the intestines are freed. 

Some persons are apprehensive as to the quan- 
tity of water the large intestine will hold with 

106 



Benefits of the Inner Bath 

safety. Let me reassure them. It is capable of 
hplding about three gallons without too great dis- 
tention. One-third of this amount, however, is 
quite sufficient to bring away the accumulated fecal 
mass, and in many cases a much smaller amount 
will answer the purpose — especially when, as ad- 
vised, it is used two or three times within twenty- 
four hours. After a thorough evacuation, water 
should be injected one or more times until it re- 
turns clear and free from fragments of feces. 

If I were asked to name the greatest curse 
parents could inflict upon their helpless offspring, 
I would say fecal auto - intoxication. A large 
volume could be written on the subject, and I trust 
the hints here given will lead to discussion of this 
grave matter. 



X07 



CHAPTER XIII. 

Objections to the Use of the Enema Answered. 

THE privilege of raising objections belongs to 
the ignorant as well as to the intelligent. But 
the objector is under as great obligations to state 
his reasons as the advocate. 

The first plausible objection to the use of the 
enema is that it is not natural. 

Admitting this charge, I would say that, inas- 
much as proctitis, colitis, and constipation are un- 
natural, the use of a preternatural or, in other 
words, a rational means to overcome the conse- 
quences of these diseases is imperative. The 
enema is such a means. 

Can any one that suffers from proctitis, etc., 
have a natural stool ? Unnatural conditions require 
preternatural aids, as we all know. The injected 
water dilates the constricted portion of the gut and 
arouses a revulsive impulse to expel the invading 
water. In obeying this impulse, the imprisoned 
feces, gases, etc., are ejected with the water. 

It may be unnatural to put water into the rec- 
tum, etc., but once there its expulsion from healthy 
bowels would be quite natural. No natural action 
can be expected from unhealthy bowels ; they do 

*o8 






Objections Answered 

the best they can under the circumstances. Eye- 
glasses, false teeth, crutches, etc., are unnatural 
but invaluable aids, but no more so than is the 
enema as a means of relief from overloaded bowels. 
The enema, moreover, be it noted, not only aids 
the system by relieving it of its load : it cleanses 
and soothes an organ that must keep at work 
and perform its function even when invaded by 
disease. 

Surely it is unhygienic and irrational to ignore 
the valuable service of the enema in cases in which 
the bowels are in an unnatural condition. 

The second objection is that the water will wash 
away the mucus from the mucous membrane of 
the bowels and leave them dry and parched and 
thus apt to crack and break in two. I would re- 
mind the objector that, since about seventy-five per 
cent, of the normal feces is water, it seems strange 
that so great a quantity of water in contact with 
the mucous surface of the bowels should not also 
cause dryness. 

The integument of the body and that of the 
mucous membrane are similar in structure, yet who 
ever had a fear of producing dryness of the skin by 
much application of water? The mucous mem- 
brane is simply the skin turned inward ; and since 
it is much more vascular it is less apt to become 
dry — if, indeed, its dryness were at all possible. 
The objector should also remember that the body 
is composed of over eighty per cent, of water— an 
organism not to be made dry or parched by the 
109 



Intestinal Irrigation 

application of water to the skin or to the mucous 
membrane two or three times a day. 

The mucous membrane of the lower bowel is not 
unlike that of the mouth, throat, or stomach. Do 
you realize how often the upper end of the intestinal 
canal is washed or bathed daily with liquids, — soft 
and hard drinks, hot and cold, — especially by those 
who have formed the drink habit instead of the 
enema habit ? They have no fear of drying the 
mucous membrane thereby ; but, if you can instill 
this fear, they will increase the quantity with 
pleasure ! 

This second objection, being the result of too 
vivid an imagination and too little reflection, is a 
very nonsensical objection indeed. 

A third objection is that if you begin the use of 
the enema you will have to continue its use ; you 
can't stop, and, lo and behold ! the enema habit is 
formed, — a new habit in addition to the many 
habits civilized man is already carrying : the con- 
stipated habit, the physic habit, the sand, bran, 
sawdust-food habit, the muscular peristaltic habit, 
etc., — and with all these habits the poor victim of 
proctitis and intestinal foulness wonders that he is 
alive. 

Usually the first symptom of proctitis is constipa- 
tion, and for relief the enema habit should be 
formed and continued while the constipation re- 
mains. When the proper means are found to re- 
move the intestinal inflammation — proctitis and 
colitis — then the constipation will disappear, and 



Objections Answered 

with its disappearance the enema habit can be dis- 
continued. But let it be well noted that the enema 
is itself an aid in curing the cause, an aid superior 
to any other at our command. A cleanly habit 
ought not to be an objectionable one, especially in 
cases in which it is most needed to prevent toxic 
substances from entering the system. 

A fourth objection is that after taking the first 
enema the constipation is worse. 

With many persons a certain amount of undue 
accumulation of feces will excite a sufficient muscu- 
lar effort of the gut to force the dried mass through 
the proctitis- and colitis-strictured bowels. This 
unnatural effort may occur once a day or once in 
two or three days, and has doubtless been a habit 
of many years' duration. 

To introduce a new order of conduct on the part 
of the bowels requires time. If the bowels have 
been in the habit of expelling feces in the morning, 
and an enema were taken the night before, there 
might be no desire to stool the next morning be- 
cause of the fact that the bulk or accumulated mass 
of excrement was no longer there to create a vigor- 
ous call or impulse for defecation. 

But we have found the extent of local damage 
and reflex injury to the organs, and more especially 
we have found the constant absorption of poisons 
into the system, due to the presence of feces. It 
is for this reason that the elimination of feces twice 
or thrice in twenty-four hours is advised. The 
condition for which an enema is used is disturbing 
in 



Intestinal Irrigation 

and poisoning to the system. It is, therefore, a 
most unnatural condition. What is more rational, 
then, than to employ an " unnatural " yet not harm- 
ful means to bring about a more normal condition, 
one free from poisoning and irritating conse- 
quences ? 

A fifth objection is made by those who have as a 
symptom of proctitis a large development of pile 
tumors or hemorrhoids (distended mucous mem- 
brane). The objection is that at times these tumors 
or sacs prolapse very freely during the act of ex- 
pelling the injected water. But this prolapse occurs 
in many cases whether water is used or not. 

A certain amount of anal irritation caused by the 
passage of feces occurs, causing contraction of the 
circular muscular tissue that forms the anal and 
rectal canal, also of the longitudinal muscular bands 
and the levator muscles of the organs. The enema 
lessens or entirely diminishes the irritation of pass- 
ing feces, and the natural result is that the serum- 
filled sacs called piles and the tissue loosened by 
the inflammatory product would more readily pro- 
lapse during the act of defecating. It is simply a 
choice between irritation of the stool keeping the 
tissue up and no irritation permitting a prolapse. 

Of course, if there be no expulsion of feces and 
water the stretched or dilated sacs may keep their 
places in the rectum. And then again the enema 
may be used for quite a period, when all at once a 
large prolapse of sacculated mucous membrane oc- 
curs, and the enema is thought to be the cause of 



Objections Answered 

it. That this is not the cause, let it be remembered 
that in all cases of proctitis the chronic inflamma- 
tion is apt to become subacute or acute, and that 
this intense engorgement and enlargement of the 
tissue with blood and the increased fever in the 
parts often result in prolapse at any time, especially 
at times of convulsive effort at evacuation. 

Whatever follows the proper use of an enema, 
even though what follows be annoying, should not 
be blamed on the enema, for its action is most 
kindly, lessening, as it does, the irritation that other- 
wise would be more severe when the feces pass 
through a disease-constricted canal. 

The sixth objection is that the use of the enema 
will weaken the bowels, which are already too 
" weak " to expel their contents. " Atony, paralysis, 
fatty degeneration of the gut, are bad enough," say 
these objectors, " without having an enema increase 
their uselessness." Diagnosis wrong and objection 
groundless ! 

Distend and contract an organ for a short time 
two or three times a day, and it will gain in strength 
from the exercise. Every one knows that this is 
the case. What more gentle means of exercising 
the large intestine than by the enema? 

But the truth of the matter is, that in all cases of 
proctitis and constipation the diseased portion of 
the gut is too active in its muscular movements, 
contracting spasmodically, as it does, at even the 
suggestion or suspicion of feces near it. Every 
impulse of the bowels above the constricted section 
113-8 



Intestinal Irrigation 



s 



to force the feces down through the closed bore 
only intensities the spasmodic action and increases 
the muscular obstruction, compelling the victim to 
resort to some one of the many drastic means of 
relief. 

The enema does no more than kindly to dilate 
the constricted region, which, when dilated, evokes 
a harmonious concerted action of all the nerves and 
muscles to pass along and down the burden of 
feces, which, without the aid of a flood of water, 
they had been incapable of moving, and would have 
had to leave to poison the system. 

The seventh objection is quite naive : " Inasmuch 
as the Indians of this country had no use for the 
enema, why should we resort to it ? " 

The all-sufficient answer to this objection is that 
the Indians lived a natural life, while ours is artificial. 
Much can be said on this point, but the reader is 
surely rational enough to follow out the distinction 
suggested. Our lives are much more important 
than were the lives of the aborigines of this country, 
and our "demands of Nature" are more exigent. 
If your life is of no greater value than theirs, for 
leisure's sake don't use the enema ! You will be 
taking too much trouble. It really should seem 
that the cleanliness of the skin and mucous mem- 
brane, the care we take of our bodies, is an indica- 
tion and measure of our sense of refinement. An 
ancient Scripture hath it : " Let those that are filthy, 
be filthy still." It all depends upon how you wish 
to be classed — with the filthy or the cleanly. 

114 



Objections Answered 

The eighth objection to be noted is the fear of 
" poking things " (points of instruments) " into the 
rectum." 

This looks like a real objection. No healthy, 
nor even unhealthy, organ, for that matter, should 
be " abused." And what seems more likely to cause 
it trouble than to poke a hard- or soft-rubber point 
or tube through its vent in opposition to its bent 
or inclination ? Still, the muscles of the vent are 
strong, and they soon accommodate themselves to 
the practice. Their slight disinclination is not to 
be considered alongside of the relief and cure you 
effectuate by the use of the enema. 

Have no fear that the point will occasion disease 
when intelligently used. Always see to it that the 
point is scrupulously clean. Those made of hard 
rubber or metal can be kept so without effort. Soft- 
rubber points are always foul and dangerous, es- 
pecially after they are used a few times. A good 
rule is never to put a point higher in the bowel 
than is absolutely necessary. 

The ninth objection seems serious. It is that 
in taking an enema the water escaping from the 
syringe point will injure the mucous membrane 
where the jet strikes. But on examination this ob- 
jection falls to the ground ; for it stands to reason 
the jet cannot directly hit the surface for more than 
a moment. Immediately thereafter the accumula- 
tion of water will force the jet to spend its energy 
on the increasing volume, to lift it out of the way 
so that the continuous inflow may find room. 
115 



Intestinal Irrigation 

But even were it possible for the jet to strike a 
definite section of the mucous membrane during the 
taking of the enema, it could do no harm provided 
the water be at the proper temperature. And this 
is true even if a hydrant pressure be used. Not a 
few persons use the hydrant pressure of their 
houses in taking an enema. For a really success- 
ful flushing of the colon a considerable pressure is 
requisite to force the volume up and along a dis- 
tance of five feet, especially when sitting upright. 
But it is folly to use a long syringe point, since it 
is like introducing one canal into another for the 
purpose of cleansing it. Therefore, have no fear 
from the use of proper syringe points ; the jet of 
water will not hurt the mucous membrane. My 
professional brethren at least ought to know that 
the idea of such harm is sheer nonsense. 

The tenth objection to using an enema is in 
being obliged to tise it from the fact of having such 
a disease as chronic inflammation of the rectum 
and colon. Every victim hates to be compelled to 
do a thing ; and the victim of proctitis and co- 
litis is no exception to the rule. In fact, he is 
beginning to realize that unless he uses it his sys- 
tem will be poisoned by the absorption of the 
sewage waste. Let the victim object to the dis- 
ease that necessitates the use of the enema, and all 
will shortly be well. Then this objection to the 
use of the enema will indeed be the most important 
of all. 

The eleventh objection, and the most ridiculous 

116 



Objections Answered 

of all, is that it requires too much time to take the 
enema twice or thrice daily. 

I lose all patience with persons urging this objec- 
tion. Those that have little or no system with 
their daily duties seldom have time to do anything 
of importance. They suffer from " haphazarditis," 
a very difficult disease to cure, and they are in 
many cases hopeless. Usually they are an un- 
cleanly lot of people, full of good intentions, but 
their intentions, though taken often, seldom operate 
as an antidote to foulness. Their one sigh the 
livelong day is : " Oh, could we be like birds that 
can stool while on the wing or on foot ! " This 
feat of time-saving being hardly possible in the 
present incarnation and order of society, they con- 
tent themselves with making a storehouse out of 
the intestinal canal for an indefinite length of time 
as they concern themselves with external affairs of 
work or sport. A sorry lot they are, indeed, when 
they are laid up for repairs ! Many doctors, I am 
sorry to say, encourage, with a chuckle, this foolish 
practice. " Any time to stool you can manage to 
get, so that you stool at least once a day, or once 
in every two or three days ; stool when it is normal 
for you to do so." This criminal advice just suits 
the sleepy, the lazy, or the "awfully busy." 

The American habit of doing things en masse, of 
handling things in large quantities or in bulk, has 
something to do with their don't-care constipated 
habit. Small evacuations two or three times a day 
seem too much like small business, which of course 
117 



Intestinal Irrigation 

is a waste of precious time. Wholesaling, laziness, 
lack of system, hurry, are the cause of good-for- 
nothingness of body and mind. It should never be 
too much trouble to restore the lost impulse for 
stooling twice or thrice daily. 

Is it a small matter to have the main sewer of a 
city partly or entirely closed, or the main sewer 
pipe of a dwelling stopped up ? Think of the dire 
results, notwithstanding that the windows and doors 
remain wide open ! The Board of Health would 
soon deal with the negligent official or landlord. 
With very few exceptions, " civilized " men, women, 
and children are negligent and niggardly care- 
takers of the human dwelling-place — the marvel- 
ous body of man. " Lack of time," " have n't the 
time," or " no time," is the excuse they give them- 
selves and others. 

Notwithstanding the numberless victims around 
them, none of these negligent and niggardly ones 
seem to get alarmed until the secondary symptoms 
— such as indigestion, gout, rheumatism, or disease 
of some vital organ — are sufficiently annoying to 
demand attention. But I have full faith in hu- 
manity. Man does the best he knows how — as a 
general rule. But often he does n't know how ; he 
needs enlightening. 

The hints I have given will, I am confident, be 
considered and acted upon by all to whose attention 
they are brought, for, by acting upon them, nor- 
mal bodies and minds will result, and blessings 
attained heretofore considered impossible. Normal 

118 



Objections Answered 

health depends on right doing and being. Eternal 
vigilance is the price to be paid for the attainment 
and maintenance of the goal of normal life and pro- 
gress. Eliminate all waste material from the body 
and all shifty vermin from the mind, and the millen- 
nium for all things in the universe will soon dawn. 



119 



Intestinal Irrigation 




Fig. 24. 

NIAGARA FOUNTAIN SYRINGE. 
(Patented Nov. 14, 1905.) 

The above illustration represents the Niagara Fountain Syringe, to which 
can be attached the enema handle, Fig. 22, Fig. 23, or the combined enema 
and recurrent douche handle, Fig. 21, page 91. The Niagara Fountain 
Syringe is made of soft rubber and holds about two gallons of water, and 
is very handy when traveling or in need of a hot-water bottle. 



CHAPTER XIV. 

Lame Back. 

THE manufacturers of various compounds adver- 
tised in our daily newspapers and on the bill- 
boards usually select very common ailments or 
symptoms on which to exploit the merits of their 
product. They make no distinction between a dis- 
ease and its symptoms ; and why should they, when 
their sole object is to sell their goods ? 

Lame back is a common weakness of that por- 
tion of the spine usually spoken of as the "small 
of the back." As a general rule, it is an indication 
of some pelvic disease involving the anus, rectum, 
colon, bladder, or uterus. Those who suffer from 
disease of one or more of the pelvic organs will 
have at times reminders that they have a lame, 
weak, or "dead" spot at the "small of the back" 
or a little lower down on the spine. 

As an illustration, a current advertisement reads 
as follows : " Weak Backs! If you happen to be 
one of those unfortunate people with a weak, lame, 
tired, aching back, it is time you were finding out 

about ■ ." Then the advertisement proceeds to 

tell how to put on a plaster or a liniment, or rub 
the back for a week or two with the hands. An- 



Intestinal Irrigation 



other enterprising wonder-worker asks : " Do you 
get up with a lame back ? Thousands of women 
have kidney trouble and never suspect it." " Lifted 

from the depths of despair by " etc. Now, this 

may be seriously alarm- 
ing to actual sufferers 
from lame back. 

The kidneys are lo- 
cated several inches 
above the region called 
the " small of the back " ; 
therefore, a difficulty in 
this region does not 
necessarily indicate dis- 
ease of the kidneys. 
Those who suffer from 
the symptoms de- 
scribed — lame, weak t 
hot, dead spots, lum- 
bago, rheumatism, etc. 
— at this portion of the 
spine may suspect that 
some of the organs in 
what is called the pel- 
vic cavity are causing them. The spinal nerves 
(lumbar nerves) on leaving the " small of the back" 
and proceeding lower down are distributed to the 
anus, rectum, bladder, uterus, etc., and when one 
or more of these organs are diseased the victim 
will have some of the symptoms in the portion of 
the back mentioned above. The earlier indica- 




Fig. 19. 

Showing the distribution of the sym- 
pathetic nerve about the rectum. 22, 
the rectum ; 23, the bladder ; 26, the 
kidney ; 20, the rectal plexus; 19, the 
vesicle plexus; 18, the sacral ganglia; 
21, the lumbar plexus; the lumbar 
ganglia; 16, the mesenteric plexus; 15, 
the solar plexus; 27, the aorta. 



Lame Back 

tions of a disease are usually localized, but, as the 
malady itself persists indefinitely, both the sufferer 
and his physician are often deceived as to the pro- 
ducing cause of the varying symptoms manifesting 
throughout the body. 

In this brief chapter I will confine myself to the 
diseases of the anus, rectum, and colon, as causing 
so much annoyance from the symptoms enumerated 
at or below the " small of the back." The most 
common ailment that afflicts mankind is chronic 
catarrhal inflammation of the anus, rectum, and 
colon. The disease invades not only the mucous 
membrane but the whole bowel structure, and the 
nerves report from the seat of the trouble up to 
where they enter the spinal column — a region that 
should be called the porous-plaster region rather 
than the " small of the back." 

The chronic inflammation involving eight to ten 
inches of the lower portion of the intestinal canal, 
like all other diseases, has its alternating periods of 
quietude and excitement ; and the negligent suf- 
ferer must count on having " stitches in the back," 
— cold in the back, lumbago, rheumatism, sciatica, 
etc., as they are usually called for want of a defi- 
nite idea as to the cause of the annoying symptoms. 
The physician consulted usually agrees with the 
sufferer's diagnosis, and coincides with the applica- 
tion of bands, porous plasters, liniments, etc. — which 
may allay the neuralgic symptoms to some extent. 

The reader is so familiar with illustrations in the 
newspapers and on bill-boards of a man with a 
123 



Intestinal Irrigation 

weak or lame back that it is unnecessary here to 
take up space with a pen picture descriptive of the 
symptoms and attitudes of a sufferer. 

Those who have had occasion to acquire the 
warm-band, the rubbing with liniment, and the 
plaster habits, had better direct their attention and 
remedies to the cause of the symptoms. One fre- 
quent source of all these back symptoms is chronic 
inflammation of the anus, rectum, and colon, with 
more or less ulceration accompanying it. In the 
female, disease of the uterus complicates the pain- 
ful symptoms. Usually among the first indications 
of this disease is some degree of constipation, which 
in time is followed by local symptoms known as 
piles, fissure, itching tabs, clot of blood in a vein, 
abscess, etc. Constipation is a prolific cause of 
indigestion, biliousness, flatulency, loss of appetite, 
self-poisoning, anemia, emaciation, uric acid, neur- 
algia in various parts of the system, catarrhal in- 
flammation of the mucous membrane of one or 
more organs, and many other symptoms. 

A diseased or^an is a constant source of uncon- 
scious and conscious irritation to the sufferer. If 
the victim can tolerate the trouble he seldom seeks 
treatment. " I will not bother with it as lone as it 
is no worse," he says. At times, however, the symp- 
toms become very annoying, and measures are 
taken to allay them. During the long interval of 
"better and worse" effects the malady is becoming 
more deeply seated, and the symptoms eventually 
appear in all parts of the body. 

124 



Lame Back 

As a rule, the majority of victims put off treat- 
ment until a protracted period of extreme suffering 
or the fear of a fatal ending compels them to con- 
sult a physician — who labors at a great disadvan- 
tage in seeking to effect a cure on account of the 
long neglect. 

Severe symptoms located at the porous-plaster 
region of the spine, when brought on by disease of 
the lower bowel, usually indicate an acute stage of 
chronic inflammation and retention of feces and 
gases in the sigmoid flexure and colon. Acute or 
subacute inflammation and fever and pressure of 
the feces are more than the long-abused nerves can 
endure, and severe pain is the result. 

Then the sufferer has something to say about 
his back, and what is best to do for it. 

The logical course is to unload the bowels of 
feces and gases by a generous use of the enema 
and to treat the diseased tissues kindly. The symp- 
toms will soon disappear when the cause is removed. 



12S 



CHAPTER XV. 

Uric Acid. 

A SOCIETY leader, in speaking of her ills to a 
woman friend, said : " I am ' lousy ' with uric 
acid." From infancy to old age, mankind is more 
or less filled with uric acid and other poisons — the 
result of a foul intestinal canal. Poisoned blood is 
a common symptom, and it arises from an almost 
universal cause — chronic constipation. So univer- 
sal is constipation of the bowels in illness that it is 
the first duty of a physician to prescribe some 
remedy to unload them. 

It is said that a Boston doctor, whose practice 
was largely among the wealthy classes, used to say : 
" There is no use in physicians pretending to be 
anything else — they always smell of rhubarb." And 
in an address to a class of medical students an old 
doctor once said that he and his associate practi- 
tioners had found that calomel and opium filled 
every want in the ills they were called upon to 
treat. 

For ages all mankind has striven to find a remedy 
effectively to clean the intestinal tract. Pills, pow- 
ders, tablets, wafers, suppositories, salts, teas, can- 
dies, and syrups have been administered — all with 

126 



Uric Acid 

that sole purpose. Efforts have been made to 
accomplish this object by utilizing every possible 
device and contrivance known to human ingenuity. 
Calisthenics, massage, physical-culture exercise, 
mental therapy, horseback riding, " dieting," fast- 
ing — these are some of the many means resorted 
to in order to " sterilize" the foul, constipated in- 
testinal canal. 

Albeit that the cleaning of the digestive appara- 
tus in the case of a sick person is regarded as 
a necessary first help the world over, few persons 
realize that it is of equal importance in the case of 
a seemingly healthy person. Is it not a fair infer- 
ence, therefore, that where a purgative — such as 
calomel, or one of the innumerable similarly-acting 
medicines — temporarily relieves a patient's symp- 
toms, the timely precaution of keeping the intesti- 
nal canal and system clean would prevent a person 
from getting ill ? 

The reader may think that, in these observations, 
I have wandered away from my text, but, as uric 
acid is the symptom of a combination and complica- 
tion of disorders of which constipation is the sec- 
ondary cause, the connection and sequence of my 
remarks are evident. It is safe for a layman to 
assume that, where so many diverse schemes are 
employed to relieve symptoms, the diagnosis is 
wrong — -also the treatment. 

A few of the many primary symptoms of procti- 
tis and colitis are constipation, diarrhea, indi- 
gestion, biliousness, flatulency, putrefaction, and, 

127 



Intestinal Irrigation 

gaseous and bacterial poisons — a foul gastrointesti- 
nal canal, through which there are daily absorbed 
from the bowels two-thirds to three-fourths of the 
excrementitious matter into the system. With 
these facts before us we need not be astonished 
at the statement that nine-tenths of human ills 
have their origin in the digestive apparatus. 

Among the secondary symptoms of proctitis 
and colitis is poisoned blood — anemia, which is 
usually followed by impaired nutrition and emacia- 
tion or obesity. Along with the changes in the 
blood and nutrition there occurs lodgment or de- 
posit of salts, acids, etc., in the various organs and 
tissues of the body. Almost every one is familiar 
with gouty deposits in the finger joints and other 
joints of the body. If the deposits occur in the 
muscular tissue it is called rheumatism. If in the 
urinary organs we have gravel, Bright's disease, 
diabetes, cystitis, irritation of the neck of the blad- 
der, frequent calls to urinate ; and the urine, scanty 
and high-colored, on cooling reveals a crystalline 
deposit. The principal mineral substances of the 
urine are as follows — of which one or more may 
become poisonous : chloride of potassium, chloride 
of calcium, chloride of magnesium, chloride of so- 
dium, sulphate of potassium, sulphate of soda, sul- 
phate of magnesia, phosphate of soda, and phosphate 
of potassium. 

The liver gets its share of the foul substances 
generated in the intestinal canal, which cause con- 
gestion of the organ. Toxic biliary salts and 

128 



Uric Acid 

acids are present. The deposit may form gall- 
stones, and jaundice and many other annoying 
symptoms may occur. The system is simply a 
filter, or blotter, that lets the poisonous contents of 
the intestinal canal pass through and out ; but all 
the organs and tissues, during the process, retain 
many of the foreign toxic substances, which over- 
tax (and frequently destroy) their functions with 
work that Nature never intended they should do. 
Think of it — all the organs and tissues around the 
intestinal canal serving as fecal vents ! Deposits 
cause irritation of nerve centers and nerve cells 
precisely as in fibrous and cartilaginous tissues ; 
and we speak of the symptoms as spinal irritation, 
hysteria, chorea, lumbago, sciatica, nervous tension, 
headache, irritability, despondency, melancholia, 
insomnia, dementia, etc. From the disturbance of 
the voluntary and involuntary nerves we have ir- 
regular circulation of the blood from disturbed 
heart action, cold hands and feet, and flushing of 
the face alternating with pallor, vertigo, and dizzi- 
ness. The capillary circulation becomes obstructed 
with crystallized bodies, as chunks of ice obstruct a 
stream of water. 

Catarrhal inflammation of the mucous membrane 
is set up in various parts of the body by the de- 
posits in the membrane and the abnormal means 
of their elimination through it. The skin of the 
body, which is the mucous membrane turned out- 
ward, suffers likewise from diseases having numer- 
ous names. 



Intestinal Irrigation 



&• 



Doctors have always expressed a poor opinion 
of the liver because it did not keep the bowels 
sweet and clean, and they mistakenly though hon- 
estly called it " the lazy liver," "the torpid liver," 
" hepatic insufficiency," " atony of the liver," " slug- 
gish liver," "hepatic torpor," " fatty liver," etc.; and 
the poor victim of proctitis and colitis was glad he 
had consulted the doctor and learned "just the 
cause " of his internal troubles — and could suffer 
on more reconciled to his malady since he knew its 
exact name and could continue to take with regu- 
larity one or more of the many powerful liver ex- 
citers, to stimulate activity in the liver and bowels 
once every day or two, if possible. By some strange 
psychological or other influence of late years, how- 
ever, physicians have turned their attention to the 
" lazy kidneys," and now it is difficult to decide 
which they are purging the most — the liver or the 
kidneys. At any rate, they both must be violently 
excited at the same time, and we hear " lithia " men- 
tioned, or " laxative salts of lithia," every time uric 
acid is thought of. Stimulate the lazy liver and 
kidneys, and with abundant salts dissolve out of the 
tissues and blood the precipitated deposits ; this is 
the fashion of the times. 

Diagnosis wrong and treatment harmful ! Water 
is by far the best agent to dissolve salt com- 
pounds, to dilute acids, or to remove filth. It is also 
the best means of soothing and relieving the long 
irritated and inflamed tissues and organs, that have 
had from two-thirds to three-fourths of the daily 

130 



Uric Acid 

fecal mass thrust upon them and collected in them, 
when they are called torpid, lazy, and whipped up 
unmercifully by bile and urine bouncers. We our- 
selves would be very torpid, sluggish, or " lazy " if 
called upon to do the work of two persons under 
such embarrassing physiological circumstances as 
being filled with toxic substances, or thoroughly 
auto-intoxicated. 

When will common sense take the place of 
theories founded on guesswork, and some thorough 
washing out by plain or distilled water be done, 
internally as well as externally ? After such an 
operation some specific remedy may be taken, if 
demanded, with the certainty of permanent good 
resulting. But remember, your aqueous body, held 
in its form by the skin and mucous membrane, 
needs a well-nigh constant stream of pure water 
flowing through it to keep it fresh and clean. 

The diagnostic error of mistaking effect for cause, 
however, is frequently made. Patients are treated 
for one of the secondary symptoms — say uric acid 
— with a view to abate that disorder and restore 
health, when treatment for the specific cause of 
constipation — proctitis (inflammation of the anus 
and rectum) — would restore the patient to his nor- 
mal vigor. Pale, anemic sufferers from constipa- 
tion are often told that the restoration of their 
blood to its normal state will effect a complete 
cure. No idea could be further amiss, for if the 
poisoned victims take coal oil, fish oil, malt com- 
pounds, iron, etc., as tonics, into a disordered 

131 



Intestinal Irrigation 

stomach and unclean bowels, how can anything 
more than imaginary relief be obtained ? Is it not 
evident that the chief disorder, proctitis, the main 
cause of the trouble, has in no way been reached ? 

In other complications arising from constipation, 
a favorite diagnosis is one of the secondary symp- 
toms — "atony" of the bowels, liver, or kidneys. 
In these cases nux vomica and various poisonous 
compounds are given, but here also it stands to 
reason that the administering of remedies for symp- 
toms cannot effect a cure of a chronic local disease 
of the anus, rectum, or colon. Then, again, by 
way of variety, a diagnosis of " uric acid " is made 
for which irritant drugs are administered to in- 
crease the eliminating or excretory action of the 
bowels and kidneys. It is utter folly and absurd- 
ity to attempt the cleansing of the intestinal tract 
by laxatives, cathartics, purgatives, exercise, etc., 
and to make the kidneys and liver, overtaxed 
from foul bowel products, do still more work by 
giving medicines to increase the urinal and biliary 
secretions. 

It does not require a knowledge of the principles 
of physiology and pathology to know that no suf- 
ferer from chronic constipation can be permanently 
benefited if any or all of the secondary symptoms 
already noted be treated with the usual list of drugs 
and the cause ignored. 

Much stress is laid upon the quantity and quality 
of food consumed by most people, and many gen- 
eralizes attribute chronic constipation, uric acid, 

132 



Uric Acid 

etc., to this very thing. Surely the average person 
knows that too much or too little food taken at 
regular intervals is not conducive to good health — 
a view that I have found borne out by a laro-e 
majority of my patients, who rarely overstepped 
the limits and knew when a diminution in the 
supply of nourishment was advisable. 

In the last analysis, the principal cause of ill 
health is lack of elimination of the excretory or- 
gans. When the bowels fail to do their proper 
work, the functions of the other organs of the body 
become correspondingly affected and impaired, and 
general debility ensues. 

In previous chapters, also in my book, Intestinal 
Ills, I have made plain the causes contributing to 
chronic constipation and the use of enemas and 
their origin. Prehension and elimination are two 
subjects that are vital to the welfare of man. If 
the eliminating power of the intestinal canal is 
normally active, the fortunate individual may eat 
abundantly, or really in excess of the requirements 
of the system, and still escape any ill effects, such 
as indigestion, biliousness, acid in the urine, etc. 
The hearty consumer of food whose bowels elimi- 
nate properly may suffer a loss of appetite, but it 
will not be accompanied with foulness of the diges- 
tive apparatus. 

When all the organs of the body perform their 
functions in a normal manner, no part of the struc- 
ture is in immediate need of repair. Every organ 
whose function consists in building tissues, muscles, 

133 



Intestinal Irrigation 

or some other part of the body, having a sufficient 
supply of reserve nutriment on hand, makes known 
this state throughout the organism ; hence there 
is no craving for food, no appetite, although the 
tongue, stomach, and intestines are in a normal 
condition. In this state of surplus of nourishment 
the person may omit a few meals or partake spar- 
ingly until the expenditure is equal to the income. 
But such physiological happiness is not for the per- 
son whose intestinal canal and system are clogged 
and foul from undue retention of excrementitious 
material, causing no desire for food, while all the 
atomic builders of the body are wanting nourish- 
ment and protesting through the nervous system 
against their impoverished condition. 

Sufferers from self-poisoning, as described in this 
chapter, should irrigate the system thoroughly by 
frequent drinking and by copious injections of 
water into the bowels. The action of the enema 
if properly given and the drinking of water that 
is pure or distilled increase the quantity of urine 
and diminish the renal congestion, while increasing 
the eliminative action of the skin. 

Irrigation of the bowels for fifty minutes or 
more with hot water (120 to 125 degrees) increases 
the action of the kidneys. Hot irrigation (125 to 
135 degrees) is especially recommended to increase 
the discharge of urine and the action of the skin, 
and should be continued for sixty minutes or more. 
The Intestinal Recurrent Douche, described in a 
subsequent chapter, is an excellent instrument for 

134 



Uric Acid 

the employment of hot water to produce diuresis 
and diaphoresis. 

The Chemung Spring Water and Clynta Double- 
Distilled Water, sold in New York, are excellent 
drinking waters and can be obtained at a moderate 
price. 



135 



CHAPTER XVI. 

Rational Sanitation and Hygiene. 

WE, all of us, like to use things ; indulgence is 
enjoyable, but it generally ends with the 
day. Few of us "take thought of the morrow." 
Neglecting, as we do, the instruments of use, their 
availability for permanent subservience to our 
wants steadily diminishes, becoming finally lost. 
Is it that we do not know any better, or is it that 
we are really so intoxicated with the Present that we 
simply ignore the well-known claims of the Perma- 
nent ? Whatever the explanation may be, it is 
nevertheless passing strange that little or no care 
is bestowed on either our external or internal servi- 
tors, instruments, or organs, which otherwise are 
ever ready to keep us well filled with the pure wine 
of joy. Perhaps it is that many of us find Nature 
so lavish in supplying us with the means of joy that 
we are naturally equally lavish in wasting them. 
True economy — that is, the conserving of means 
for their effective use — is yet to be learned by man. 
Especially is this the case with our interior means, 
our flesh, blood, nerves, vital force, etc. Nature 
seems so ready to recoup and renew the organic 
loss incurred by our use or indulgence — recupera- 

136 



Rational Sanitation and Hygiene 

tion seems so easy — that we simply grow careless, 
reckless, prodigal, and before we are fairly aware 
of it the disintegrative process gains an ascendency 
over the restorative, and thenceforward our time 
will be spent in endeavoring to cure what might 
have been kept whole or well. 

Nor is it an organ of the body here and there 
that we neglect or abuse ; it is more especially the 
entire system of organs called " the body." The 
body is the organ of man's spirit. We give no 
heed to its tones ; perhaps we have never caught 
its rhythm ; certain it is that when but a short time 
in our perverted hands its chords are more or less 
jangled, and a minor part is played in the grand 
symphony of life. 

The organ of man's spirit ! How rational, nay, 
how necessary, it would seem to be to keep that 
instrument keyed to its perfect work ! 

But the ordinary denizen of civilization has a 
most ridiculous ideal of physical capability, namely, 
that the savage — a being altogether " physical " — 
was able to retain a healthy body till ripe old age 
without attention either to sanitary surroundings 
or to the hygienic functioning of his system of or- 
gans. The " civilizee's " fancy picture of the noble 
savage is not based upon verifiable fact. It is true 
that we have a few attractive myths concerning 
savages that had survived appalling hardship ; but 
we are just learning of the innumerable host that 
have perished periodically of various contagious 
diseases, and of the countless number (infants, 
137 



Intestinal Irrigation 

youths, and adults) that have suffered from all 
sorts of ailments. Alas ! how little we know — 
or, for that matter, how little we seem to care — of 
the great multitude of " civilized " fellow-creatures 
whose lives are all jangled and out of tune through 
subjection to the many ills that flesh seems heir to ; 
ills that have arisen through either ignorance or 
the voluntary ignoring of the light of accessible 
knowledge / 

In another aspect the human race is like an army 
that concerns itself with its immediate and impera- 
tive duties and has no time or thought to bestow 
on those that fall out of the ranks. But slaves to 
stern duty offend against Nature's normality as do 
slaves to desire ; and the former little suspect that 
their retirement also is near at hand. In health we 
seldom or never think of the conditions for the 
maintenance of health. That these conditions 
should receive our prime attention is obvious when 
we contemplate for a moment (i) our race of inva- 
lids, and (2) the growing unsanitary condition of 
modern industrialism, involving, as industrialism 
perforce must, the unsanitary life of the factory, 
workshop, office, and hothouse home. 

Again, with the advance of high-pressure civiliza- 
tion and culture human beings are developing a 
more highly sensitive physical organism, pitched 
to finer issues. How urgent the necessity for a 
greater safeguarding of that organism ! 

If it be claimed that many of us do live up to 
our knowledge of health conditions, and that we 

i 3 s 



Rational Sanitation and Hygiene 

are notwithstanding unwell, I would answer that our 
knowledge now is very disconnected, and that when 
the time shall come that our itemistic information 
shall have coalesced and formed a system of princi- 
ples, we will then have trustworthy rules for the 
acquisition of health habits and become completely 
normal physical beings. At present most of us are 
intemperate in one or more ways. We eat too 
much or too little — too rich or too poor food. So 
it is with our drinking, our sleeping, our sporting, 
our enjoyment of this or that excitement — the 
quantity or the quality of each of these is not 
well adapted or proportioned to the conditions of 
normality. 

Let me offer the health-seeker a few indications 
of the sanitary and hygienic requirements demanded 
by Nature's normality. In our family and house- 
hold life, to carry into execution daily hygienic 
measures, it is essential that we have ample, access- 
ible .conveniences for the necessary ablution of the 
body, externally and internally. How extremely 
rare it is, however, that bath-tubs and water-closets 
are found in sufficient quantity and suitable quality 
in our apartments. As household fixtures they are 
usually about as scarce as hens' teeth. 

In New York City a house with from eight to 
sixteen persons is restricted to the use of one water- 
closet and one bath-tub. On these (and a laundry 
and servants' privy in the basement) there is the 
tax of ten dollars a year. Now, should that rare 
human product, an enlightened and humane owner, 

139 



Intestinal Irrigation 

put in eight more bath-tubs and water-closets for 
the proper accommodation of his sixteen guests, so 
that each suite of sleeping apartments should have 
its appropriate conveniences, he would have to pay 
an additional tax of forty dollars a year. Is this 
tax levied with the connivance of the Board of 
Health ? It would seem so, since no protest from 
that august body has ever been heard within the 
memory of the oldest inhabitant. Indeed, the sus- 
picion is not at all unwarranted that if the masses 
were less constipated and better washed they would 
have less use for the doctors, and that, therefore, 
it is not well to encourage undue sanitation and 
hygiene. 

It must be, too, that the Department of Water 
Supply has figured it out quite beautifully that a 
saving will be insured in the amount of water con- 
sumed by sixteen persons if they be restricted to 
one bath-tub and one water-closet ; otherwise forty 
dollars a year would not be charged for eight ad- 
ditional tubs and closets for the use of the same 
number of persons. Listen to a sample of their 
logic : " Sixteen persons with eight additional bath- 
tubs and water-closets would use more water than 
if they were restricted to one of each — hence 
the additional tax. We don't care a continental 
whether these human beings are clean externally 
or internally ; that 's not our lookout. But we do 
care that they should n't use more water than just 
so much, see ! " 

And does the august Board of Health raise the 

140 



Rational Sanitation and Hygiene 

least objection to this sort of logic ? None what- 
ever. 

Professor C. S. Smith states that, out of 255,000 
families in tenement-houses in the city of New 
York, only 306 had access to bath-tubs in their own 
homes in 1894. In 1897 one city block containing 
904 families did not have a single bath-tub. 

Paradoxical as it may seem, there is, notwithstand- 
ing the appropriation every year for the New York 
City Board of Health of over one million dollars, a 
prohibitive tax on bath-tubs and water-closets — that 
is, on cleanliness — prohibitive on all homes except 
those of the wealthy. Is it to be wondered at that 
contagious diseases are prevalent, especially during 
the winter months, and that we have so many acute 
and chronic maladies ? 

Let me make a suggestion here for the serious 
consideration of our city fathers : Reduce the ap- 
propriation for the Board of Health to two hundred 
thousand and give the other eight hundred thou- 
sand to the Department of Water Supply, so as to 
abolish the tax on water-closets and bath-tubs. If 
every citizen of New York could have all the water 
he needed for cleanliness and comfort, there would 
be little excuse for the existence of such a body as 
the Board of Health ; its existence would then be 
more honorable than onerous. Furthermore, the 
city, as a corporate body, should manufacture bath- 
tubs and water-closets, and furnish them at cost. 
Thus would it insure a great stride toward the 
health of its own citizens. When the disease-pro- 

141 



Intestinal Irrigation 

ducing microbe becomes scarce, the occupation of 
the Health Board pathologist will be gone. Hold ! 
Could he not devote his time profitably to studying 
the habits of health-producing microbes — for there 
are such ? Microbes are absolutely necessary for 
higher forms of existence, it being now well known 
that some microbes are destructive or pathological 
and that others are constructive or physiological. 
Is it not much wiser to spend our millions of dol- 
lars for the prevention of disease than for quaran- 
tining it? Inducing, and even compelling, people 
to be clean is a far better policy than to compel 
them to be vaccinated. 

Now, we pay the Board of Health many thou- 
sands of dollars a year simply for making cultures 
of disease-producing bacteria so that antidotes may 
be found. The pictures and history of these bac- 
teria are published in many large volumes, costing 
the city several hundred thousand dollars a year. 
Scientific as this practice undoubtedly is, it is very 
expensive — and needless. 

Every year thousands of children and invalids of 
New York receive improper nourishment, or are 
made positively sick, on milk that is either foul, 
stale, or ready to sour ; and every summer thou- 
sands of children die from complaints traceable to 
this source. Swill milk is one of the great genera- 
tors of disease-producing germs to which all sorts 
of "complaints" are due. Does the Board of 
Health care a fig for the generator? No; the 
Board is absorbed in watching the antics of the 

*4* 



Rational Sanitation and Hygiene 

germs ! Mighty intellects are searching for malig- 
nant, multitudinous mites. Yet there are just a 
few mites of common sense in existence, which if 
encouraged will breed quite as fast as the sinister 
ones. Indeed, there must be one or two at work 
in myself, for I seem to be urged to say that if our 
City and State Boards of Health should see to it 
that our cows are kept clean and healthy, our milk 
clean and pure, our cans clean and well scoured, 
and our shops and ice-boxes clean and free from 
odor, there would be no occasion for germ cultures 
of diseases brought on by swill milk. 

Our milk example will illustrate what germs of 
common sense would do to ward off all kinds 
of disease-producing micro-organisms. Rigorous 
regulations, well enforced, as indicated above, would 
work in other lines as well. And when the source 
is gone sinister microbes will not come into exist- 
ence, and diseases that have resulted from such 
microbes will have gone into innocuous desuetude. 

There should be a bath-tub and a water-closet in 
every suite of sleeping apartments. When this is 
the case, there will be a larger number of persons 
clean internally and externally, and the doctors 
will be on a hunt for health-producing germs in- 
stead of disease-producing ones. Let us start an 
organized movement in this direction. 

Last summer Medical Science went about killing 
mosquitoes on Staten Island with a little spraying 
apparatus, and managed to disturb the pest for a 
day or two from its customary bivouac. Christian 

143 



Intestinal Irrigation 

Science stood aloof and smiled superciliously, claim* 
ing that " there are n't any such things as mosqui- 
toes ; but if they should prove to exist, there is n't 
any malaria anyhow." Good sense might have 
suggested to Medicus the draining of the ponds for 
gardening purposes ; and, if that were not possible, 
the filling in of the edges and the making of deep- 
water lakes for the sport-loving youth, who might 
be depended on to keep the water stirred up by 
boating, etc., free of charge, and thus convert a 
pest pond into a pleasure lake. Pleasure and 
cleanliness are taxed to-day for disease and pests. 
Oh, human imbecility ! 

As to public baths, there are so many objections 
to them that I cannot touch on the subject in this 
chapter. But let me impress upon the health- 
seeker, the public-spirited citizen, and our city 
officials that what we urgently need are ample 
conveniences in our homes for internal and exter- 
nal cleanliness — conveniences easily accessible sev- 
eral times a day, every day of the year. 



144 



CHAPTER XVII. 

Personal Cleanliness. 

AT the close of my last chapter I referred to the 
ever-recurring problem of public baths. An- 
nually its agitation is renewed in lectures and 
newspapers ; public bathing is voted without dis- 
agreement the thing of things needful to render the 
laity — i. e., the labor population — physically pure. 
It is the long-felt want; but, like the longed-for 
walk of the annual Sunday-school parade, it is soon 
done and gone. Still, we must have patience with 
those dear souls, our ethical teachers of the press 
and platform, for taking such a deep, sentimental, 
though unscientific, interest in the welfare of the 
unclean. Owing- to the non-existence of home 
facilities for cleanliness among the working class, 
the accumulations of soil and exudation during the 
long fall, winter, and spring months are so great 
that their bodies become too rank and malodorous 
for the nostrils of the refined. Consequently, as all 
animals seek the tepid water of the summer, and as 
man is no exception to a capacity for laving in the 
circumambient fluid, to three-fourths of the popula- 
tion of this metropolis it must be a glorious peren- 
nial treat to dip in the river, bay, or sea ; and it 



145-10 



Intestinal Irrigation 

must indeed be a dire necessity to those that have 
managed to survive contagious and other diseases 
during their long immurement. Without this sum- 
mer cleansing few animals, bestial or human, would 
run half their average careers. It is accordingly 
not strange that during the summer a bath in open 
water is a daily hygienic necessity and source of 
joy to thousands of creatures. 

Now, it is just because godliness appears in the 
wake of cleanliness that I made so strong a plea in 
my last chapter for ample bath-tubs and water- 
closets. For I do not approve, nay, I emphatically 
condemn, the system of public baths along the 
shores of our rivers and bay. Their waters are 
contaminated by numerous sewers, and bathers 
have contracted many contagious diseases that have 
become epidemic in neighborhoods. Note espe- 
cially the annoying eye troubles that follow in the 
wake of such bathing. Of course, the sport and 
exercise involved in open-water bathing are highly 
commendable ; but the danger of contracting con- 
tagious disease, and the outrage of the sense of 
refinement when contemplating fellow-creatures 
in the act of stirring up polluted waters, should 
call a halt to our encouragement of public bath- 
ing in and around our metropolitan water fronts. 
These waters are surely anything but a means of 
cleanliness. 

The water-closet, however, is of far greater im- 
portance than the bath-tub, and especially than the 
public water-gymnasium — which last is so much 

146 



Personal Cleanliness 

lauded by some of our misguided philanthropists. 
Intestinal foulness, as a prolific source of disease, is 
of far more serious importance than surface foulness. 
However, both the bath-tub and the water-closet 
are indispensable to every suite of rooms. 

Another need imperatively demanded by the exi- 
gencies of city life is the establishment of public 
water-closets at several thousand convenient cen- 
ters throughout this great city. At present the 
male population, when away from their residences, 
are obliged to make use of a near-by saloon — a 
most uncertain resort, and one in which courtesy 
will generally constrain them to imbibe intoxicants 
nolens volens. The female population have not 
even the saloon as a resort, and can relieve them- 
selves only when in the vicinity of department 
stores. American enterprise can improve in many 
respects on the several European models of pub- 
lic-relief stations. The public is becoming con- 
scious of its needs and rights in this respect ; and 
one of the sanitary evolutions of city life — con- 
gested as it is — will be ample and cleanly public 
accommodations for intestinal relief. 

Americans in general suffer from dyspepsia, bil- 
iousness, constipation, uric acid, etc. — all of which 
disorders are symptoms of that world-wide disease, 
proctitis : inflammation of the anus, rectum, and 
often the colon. Nor is it any wonder that un- 
washed humanity suffers from proctitis and its con- 
sequences. The unwashed have no bath-tubs and 
practically no water-closets. This lack is due to 

147 



Intestinal Irrigation 

the tax on water facilities, to expensive plumbing, 
and to too much " science " and not enough com- 
mon sense among our city fathers. As a conse- 
quence of ignorance and inconvenience, most people 
defecate but once in twenty-four hours ; and very 
many but once in two or three days or a week. 
The once-a-day stool is frequently scanty, and as a 
consequence the kidneys, lungs, and skin are called 
upon to perform the vicarious function of elimin- 
ating a portion of the daily excrement ; and the 
colon and sigmoid flexure have to hold the stored 
contents unduly — until the feces be expelled by 
purgatives or by the irritation that the accumu- 
lated mass occasions. Could the members of the 
Board of Health and the people at large be brought 
to a realizing sense of the value of personal clean- 
liness, — internal as well as external, — bath-tubs and 
water-closets would abound in our homes. 

Man's habits as to eating, drinking, dressing, 
bathing, and especially as to defecating, are clues 
to his growth in refinement. But we must beware 
of judging a person by one or two good or bad 
habits ; he should be estimated by the sum of 
his habits and their peculiar combination. Refined 
habits are not all of them acquired at once ; they 
develop slowly, one after another, when opportuni- 
ties are favorable, especially the habits as to bath- 
ing and defecating. Opportunities for these latter 
are wofully lacking at present — the cause and con- 
sequences of which lack are pointed out in the last 
chapter. A child will derive far more good from a 

14s 



Personal Cleanliness 

ready access to bath-tub and water-closet than from 
a lifelong attendance at Sunday-school and church 
with the temple of the human soul permanently 
unclean. Only one that has learned to respect 
and care for the abode of the soul — the body — is 
worthy of being classed among the refined. It is 
truly deplorable that the great majority of the hu- 
man race are creatures of the moment or the hour, 
tolerators of abnormal functioning, slow suicides of 
vital capacities. Claims of the permanent are con- 
stantly ignored ; most of us are blind to the joy in- 
volved in the harmonious functioning of all the 
organs — a functioning that always ensues upon 
hygienic care. 

Our organs will for a time bear neglect or un- 
hygienic conditions without protesting their annoy- 
ance. Many persons never use hot water or soap ; 
others find one bath, in river or sea, quite sufficient 
for the year ; others, again, feel the need of a bath 
once or even twice a month, or even once a week. 
But there are very few of us that seem to require a 
bath daily. Many, alas ! have grown accustomed 
to a bathless existence. 

Have you ever stood near an Italian or Greek 
street vender, or have you ever been within five 
feet of a low-class Polish Jew? If so, the stench 
arising from his unwashed body must have nau- 
seated you. It is no secret that such persons never 
wash — especially the latter, who live in rooms reek- 
ing with filth. Contemplating such conditions, I 
feel impelled to propose a great, nay, the greatest 
149 



Intestinal Irrigation 

reform — one suggested years ago by Samuel Butler 
in Erewhon. Let us make Health the great civic 
virtue, and Disease, as well as unsanitary and 
unhygienic conditions, the crime. Our so-called 
crimes of theft, murder, forgery, etc., should be 
treated as weaknesses and faults to be corrected by 
Moral Rectifiers — by the preachers, priests, rabbis, 
and ethical culturists. Consider how much is im- 
plied in developing and breeding a race of healthy 
men and women. All relations of life would feel 
the vital change at once, and moral weaknesses 
would disappear. Any human cesspool entering a 
public conveyance, or in any way mingling with 
cleanly people, should be arrested, thoroughly 
cleansed, internally and externally, and seques- 
tered for a time sufficient to teach him better. 
There is a local rule of the Board of Health against 
spitting, but it is rarely enforced. There are mil- 
lions of public expectorations to one arrest. For 
the appearance in public of consumptives, and their 
offensive hawking, coughing, and spitting, no one 
seems to have suggested a remedy. All diseases 
should be classified as to grades of punishment ; 
and all moral weaknesses, such as defalcations, 
adultery, burglary, should be treated at the various 
hospitals, which latter should be conducted solely 
by Moral Rectifiers. 

In closing, I shall direct attention to a few other 
points in personal cleanliness — the mouth, ear, nose, 
and throat. 

It is important on hygienic grounds that the 

150 



Personal Cleanliness 

mouth receive proper care two or three times 
daily. 

The ear is commonly kept clean ; still there are 
many instances of non-refinement of this organ, 
and from its non-hygienic treatment deafness often 
occurs. 

The prevalent nasty, ill-bred habit of hawking 
and spitting in public, or in company, even by gen- 
teel persons, can be cured best by early training in 
correct habits. This habit, as well as the evidences 
of throat troubles, is usually to be ascribed to in- 
attention to the nose. When catarrhal conditions 
are avoided or properly treated the throat will not 
be so affected as to necessitate this reprehensible 
practice. Trouble is invited for the tonsils and 
soft palate by our constant hawking ; certainly the 
tender sensibility of the throat is destroyed thereby. 
Inasmuch as the tobacco habit is so general, and spit- 
ting is a necessary accompaniment of that habit, 
stringent laws against hawking and spitting would 
be unpopular among the masculine half of the race. 
But should public opinion ever become educated 
up to the point in which disease becomes a crime, 
opposition would cease. This consummation is 
devoutly to be wished, for then we will have 
adopted and followed Ingersoll's injunction to 
" make health catching, not disease." 



151 



CHAPTER XVIII. 

Hot Water in the Treatment of Proctitis 

and Colitis. 

IN treating chronic ulcerative inflammation of the 
anus, rectum, sigmoid flexure, etc., it is well 
to take advantage of every really practical device 
to which one may have access, so that valuable 
time may be saved in obtaining relief and effecting 
a cure. 

The capillaries, veins, arteries, and arterioles in 
an inflamed organ become distended and the tis- 
sues swollen, indurated, and tense by the excess of 
blood and the inflammatory serum deposited in 
the tissues. The vasomotor nerves in the diseased 
part have lost their contractile power, which fact 
increases the stasis, or congestion, of the blood. 
Circulation in diseased tissue depends very much 
on the general tone of the system, and if the cir- 
culation is below the normal the ravage of the 
malady is increased proportionally. 

Have you ever observed a little stream of water 
enter a large pond in which were grass, shrubbery, 
logs, decaying vegetation, and debris of all sorts — 
the accumulation of years ? And have you noticed 
that here and there there were stagnant pools, 

152 



Hot Water in Proctitis and Colitis 

without a perceptible motion from where you 
stood, but that as you reached the side opposite to 
the entrance some faint traces of motion became 
visible, and that as you followed the line it soon 
formed into a stream quite equal to the inflow ? 
The pure water, on entering and mingling with the 
stagnant water and old deposits, soon becomes 
corrupted and foul. Somewhat similar unhygienic 
and toxic results take place in ponds of stagnant 
blood and abnormal deposits such as proctitis and 
colitis involve, and where, for six or eight inches 
or more of the large intestine, inflammation is 
deeply seated, and blood stasis is of course in full 
swing. As the debris in a stagnant pond decays, 
making the water impure, so in an inflamed organ 
the tissues decay, making the blood impure. Ul- 
ceration is an exhibition of this process of conges- 
tion, induration, and decay. 

The rectum and sigmoid flexure are loosely 
hung in the pelvic space and are surrounded by 
fatty cushions of connective tissue on all sides, 
which fact allows the organ considerable dilatation 
and motion (Fig. 5). Owing to the anatomical 
structure and the location of the lower bowel, it 
becomes a serious matter when it is invaded by an 
ulcerative inflammatory process — especially when 
all the layers of tissue forming its wall are invaded, 
and still more so when the connective tissue around 
the organ is in the same condition. 

Far better were it for the victim of proctitis 
and periproctitis — filled as he is with channels and 

153 



Intestinal Irrigation 

reservoirs — if pus were to form in abundance at 
once and thus betray the destructive action in the 
spongy areolar or connective tissue, under the mu- 
cous membrane, around the rectum, and in the 
tissue forming the anus and buttocks. 

The pathological condition brought about by in- 
flammation, etc., requires a remedy that will empty 
the over-dilated vessels and remove the serum de- 
posit in the tissues, which is analogous to the 
rubbish of a pond. 

Our grandmothers were familiar with the thera- 
peutic effects of heat and moisture when they 
applied hot poultices constantly to an inflamed 
organ or limb for one or more hours until the 
tissues presented a blanched, shriveled, and white 
appearance ; if there were signs of the inflamma- 
tion returning, the poulticing was continued or 
repeated. They knew very well what the parboiled 
condition of a washerwoman's hands indicated after 
a day's work in hot water. They were bloodless, 
notwithstanding their incessant muscular exercise. 
In case of inflammation, they reasoned, heat and 
moisture would make the congestion and fever 
leave if applied long enough. On beginning the 
use of the hot poultice, the tissues to which its 
heat and moisture were applied became relaxed, 
and the parts for the time more congested than 
before ; but our grandmothers did not mind that, 
as the final result would justify their hydriatic pro- 
cedure. They well knew that after ten minutes or 
more a reverse action would take place, and if the 

154 



Hot Water in Proctitis and Colitis 

treatment were continued long enough the blood- 
vessels and tissues would show little or no evidence 
of fever or inflammation. 

Where chronic inflammation exists, the blood- 
vessels and tissues lose their normal tone or 
vitality ; consequently, they will require repeated 
application of hot water as well as other aids until 
a cure shall have been effected. 

Another great advantage in the use of hot water 
is that its application can be interrupted and re- 
sumed without detriment to the diseased tissues or 
organs. Cold water, on the contrary, causes the 
vessels quickly to contract and expel the blood, 
but, on reaction taking place, the tissues become 
more congested than before. 

In the use of water at a temperature of 120 to 
135 degrees, or even more, we have one of the 
most valuable adjuvants in all stages of proctitis 
and colitis, and, if a properly regulated plan be 
pursued in connection with the requisite local treat- 
ment, more good can thus be accomplished than by 
all other means combined. 

The layman is more or less familiar with the 
condition of a sore or ulcer in which soft, spongy, 
or fungous tissues appear, called " proud flesh," 
which, on an inflamed mucous membrane, is called 
granular tissue. Were it not for the usual presence 
of granular tissue on a chronically inflamed mucous 
membrane and for ulcerated sections or patches, 
channels, and stretched or pouched mucous mem- 
brane called piles, the proper use of hot water 

155 



Intestinal Irrigation 

alone would in time effect a total cure in almost 
every case of proctitis. 

Many well-meaning persons conceive the idea 
that, if hot water is so beneficial, they may use it 
as hot as possible for the purpose of an enema 
likewise, since they will thereby not only relieve 
the bowels of their stored feces but simultaneously 
do the inflamed tissues " a whole lot of good." 
Their spirit is admirable, for not all patients are 
prompted to such thoughtful attempts to do every- 
thing in their power to get well — even though they 
err with the best intentions at heart. Let them 
remember, however, that the first effect of hot 
water is to increase the blood supply in the tissues 
if it be applied for a short time only. In the ma- 
jority of cases, the enema does not require more 
than from five to ten minutes ; hence, only harm 
can result if really hot water be used. Now and 
then a person will become possessed with the notion 
that a hot enema should be followed by a cold 
one, to bring " tone " to the lower bowels. But 
in all these misdirected efforts matters are made 
doubly worse. 

Cold water will allay fever and inflammation, but 
when its use is once begun it should be continued 
without intermission until a cure is effected. For 
this reason it is not suitable where chronic inflam- 
mation exists — especially on the mucous membrane 
of the bowels. It is, however, excellent for acute 
inflammation of the external parts of the body, 
such as the hands, arms, legs, etc., where it can be 

156 



Hot Water in Proctitis and Colitis 

continued without interruption for one, two, or 
three days if necessary. 

In beginning the treatment for constipation, 
there are a few cases in which the patient has to 
fuss for an hour or more with the enema before he 
can obtain any sort of a proper fecal evacuation ; 
or there may be inability to expel the water from 
the bowels when once injected. This stoppage is 
most likely to occur at the recto-sigmoid juncture 
(O'Beirne's sphincter). A strictured condition of 
the bowels causes retention of feces and gases 
and why not water as well? In such cases time 
wouldbe saved, perhaps, by combining the procedure 
for an enema with that of a recurrent douche, 
which involves a continuous application of water at 
a temperature of from one hundred and twenty to 
one hundred and thirty-five degrees for an hour or 
more. Figure 21 illustrates a successful device for 
applying medicated water at a high temperature to 
the anus, rectum, and colon. This apparatus can 
be used while sitting on a water-closet seat and 
the treatment can be completed without changing 
position or removing the instrument. 

The instrument is attached to the reservoir 
(Figure 18) by a soft-rubber tube. In the cone- 
shaped piece of hard rubber (Figure 27) is a hard- 
rubber stop-cock or valve (Figure 29), and by turn- 
ing the handle sidewise the valve is opened to let 
the water escape from the bowels into the toilet 
basin. When sufficient water, at from one hundred 
and twenty to one hundred and thirty-five degrees 

157 



Intestinal Irrigation 

temperature, has entered the bowels, allow it to 
remain for ten minutes, then permit it to escape by 
opening the valve ; then close it and allow more 
hot water to flow in and remain for five or ten min- 
utes and again allow it to escape through the rectal 
point, repeating the inflow and outflow every five 
or ten minutes for an hour or more without re- 
moving the anal point from the rectum during the 
whole time of treatment. After a few trials it will 
be found that the hot-water treatment can be 
accomplished without withdrawing the point. 

Rectal Points for recurrent douche are of two 
sizes (Nos. 25 and 26). The larger one (No. 25) 
requires a plug to be introduced through the cone- 
shaped external anal support and rectal point, to 
make its introduction into the rectum easy, after 
which the plug is withdrawn and the hot-water 
treatment begun. The bore of the rectal points 
cannot become clogged by the presence of feces, 
mucus or membranous shreds or casts, which are 
usually brought away by the hot-water treatment. 
At no time during the treatment can the point 
become stopped up, the size being sufficient to 
insure a proper inflow and outflow. And the 
instrument can be easily cleaned. 

Near the attachment of the soft-rubber tube is a 
glass reservoir (Figure 24), for the use of oils with 
the enema or the hot-water treatment ; it is detach- 
able. A valve regulates the outflow of oil from the 
pressure of water in the reservoir, as it passes into 
the bowels. We are enabled thus to treat by double 

15s 



Hot Water in Proctitis and Colitis 

medication as it were, a chronic disease of the in- 
testines and its symptoms — that is, intestines that 
have been long neglected or maltreated through 
lack of proper diagnosis, or by all sorts of chemi- 
cal compounds from above, through mouth and 
stomach. 

The author and inventor naturally enjoys not a 
little satisfaction in being able to present to suf- 
ferers as nearly perfect an instrument as can be 
devised ; one that, in conjunction with other aids, 
meets all requirements involved in the proper treat- 
ment of proctitis and colitis. Lavage or irrigation 
of the large intestine with water at a temperature 
at from one hundred and twenty to one hundred 
and forty or one hundred and fifty degrees, not 
only accomplishes rapid and wonderful cleaning and 
curative results, but overcomes, when properly ap- 
plied, contracted, congested, engorged, and inflamed 
tissues of the bowels. Therapeutically, it has a 
marked effect on the whole system, being beneficial 
beyond words to describe ; it relaxes nervous and 
muscular tension of the body, producing restful- 
ness and sleep ; it stimulates and equalizes the cir- 
culation, promotes perspiration, absorption, and 
active elimination of all deleterious substances from 
all the organs of the body. Medicinally, it is really 
a combined internal Russian and Turkish bath, re- 
moving abdominal corpulency and gaseous obesity, 
resulting from chronic auto-intoxication. The ex- 
ternal Russian and Turkish baths afford a satisfaction 
skin deep to the bather, but the combined internal 

159 



Intestinal Irrigation 

Russian and Turkish bath is most agreeably relaxing 
and restful to mind and body, bringing peace, since 
all the organs of the system are performing their 
functions. Some of my patients resort to internal 
hot-water lavage for all aches and ills that mar their 
happiness. After an external bath the bather may 
desire an application of oil, alcohol, or cocoanut 
butter rubbed on the skin, and in the same way 
the bather's internal mucous membrane is not 
neglected ; for, with the author's appliance, medi- 
cated and perfumed oils, extracts, and powders for 
remedial purposes are carried to every part of the 
intestines that the water reaches, thus exerting a 
cleansing, healing, and soothing effect where most 
needed. 

A few sufferers will object to the time required 
for an enema twice a day, although they find time 
to eat three, or even four times a day, without any 
objection whatever ; there is plenty of time for fill- 
ing up the digestive apparatus, but no time for its 
normal elimination. And these miserable, go-lucky, 
haphazard people are always sick and unfortunate. 
The internal Russian and Turkish bath is demanded 
only by those who truly desire to be free from their 
bowel troubles, and from the numerous symptoms 
resulting from mucus absorption, constipation, and 
auto-intoxication. 

A sufferer's efforts to be well depend largely on 
how much he or she estimates the worth or value 
of mind and body. A noble purpose in life is price- 
less ; are not one's spirit and body worth the time 

160 



Hot Water in Proctitis and Colitis 

required for two enemata each day and an hour for 
the internal bath, if needed? I think so, and you 
should likewise. 

The author trusts the reader will not infer that 
all sufferers from piles, anal fissure, pruritus ani and 
vulvae, mucus channels and reservoirs, abscess, fis- 
tula, and all similar troubles, require the enema and 
recurrent douche appliance ; the character of the 
disease and its symptoms must determine the re- 
quirement of the treatment. Many of my patients 
receive office treatment only, omitting home atten- 
tions, although this is not always advisable. The 
reader might conclude that the recurrent douche 
treatment was simply for the cure of a chronic in- 
flammatory invasion of the bowels and fecal auto- 
intoxication, and not be aware of another great 
source of auto-intoxication — that is, from the ab- 
sorption of large quantities of serous, fibrinous, or 
albuminous exudation from a large area of tissues 
invaded by the very insidious inflammatory process, 
a condition which, in time, may reach the pus-form- 
ing stage. Thus we have three very grave patho- 
logical conditions to meet and remove before the 
pus-formation stage is made manifest through the 
development of abscesses. I have found five aids 
— perhaps more — to accomplish a cure in which I 
have been exceptionally successful, as my students 
and patients will verify ; these are : local treatment, 
local medication, the proper use of the enema, the 
use of the recurrent douche, and the determination 
of the sufferer to get well 
f6i— ** 



CHAPTER XIX. 

Hot Water in the Treatment of External 
Symptoms. 

AFTER proctitis has continued for many years 
it will give rise to painful inflammatory and 
ulcerative processes at the external anal vent and 
in the adjoining tissues. The anal mucous mem- 
brane and the integument about the anus become 
brittle, loosened, and detached from the areolar 
connective tissue by the retention of inflammatory 
serum. The engorged, indurated, and swollen 
mucous membrane and integument serve as reser- 
voirs, especially when the chronic inflammation is 
excited to an acute stage, which stage is often ac- 
companied by a fissure, abscess, or anal ulcer. 
Soreness and pain in the parts may then be so 
severe that the sufferer is compelled to stay indoors 
or in bed. Whatever the symptoms may be — piles, 
fissure, pruritus, abscess, or fistula — the sufferer 
desires to reduce the local fever and the acute 
inflammation, as well as to find relief from the pain. 
The customary treatment is to use poultices, which 
are troublesome and ineffective. 

In the following illustration I give a good idea 
of a perfect device for relieving quickly the sore- 

j6a 



Hot- Water Treatment 

ness, pain, acute inflammation, and induration, all 
of which are so very prostrating ; and, situated as 
they are physiologically, they are exceedingly incon- 
venient to treat properly by the ordinary methods 
in use : 




(Patented November 8, 1893.) 

Fig. 23. 

The Sitz-bath pan, though small, is yet of suffi- 
cient depth and diameter for all practical purposes, 
and can be placed wherever is most convenient — on 
a low chair or a box. The bather should sit on the 
instrument with the limbs on either side of the 
funnel through which the hot water enters the pan. 
Just below the funnel is an overflow tube, under 
which a vessel should be placed to catch the water 
as it flows out. While sitting on the pan the 
elbows may rest on any convenient support, so as 
not to tire the invalid too much during the bath, 
which should consume from half an hour to an 
hour, or longer if agreeable. Hot water may be 
added every few minutes as the bather finds that 
the tissues will tolerate it. Depurant powder may 
also be added to the water in the Sitz-bath pan. 
163 



Intestinal Irrigation 

What has been said in a previous chapter on the 
therapeutic effects of hot water in the treatment of 
proctitis need not be repeated here. 

The three indispensable appliances for combat- 
ing and effectually overcoming the pathological 
conditions to which this book and my two previous 
books — Intestinal Ills and How to Become Strong — 
are devoted, are The Internal Fountain Bath, The 
Intestinal Recurrent Douche, and The Shallow Sitz- 
bath Pan. These appliances are well-nigh perfect 
for the uses to which they are adapted. 



164 



CHAPTER XX. 
The Health of School Children. 

" Cleanliness of body was ever esteemed to proceed from a 
due reverence to God, to society, and to ourselves." — Bacon. 

THE International Congress on School Hygiene 
ended its fourth meeting at Buffalo recently to 
meet two years hence in Brussels. In the interim 
the Board of Education in this city, the Depart- 
ment of Health, and the New York School Luncheon 
Committee will continue their investigations as 
vigorously as in the past, and the information thus 
gained will be an important contribution to the 
next Congress. 

Too much attention cannot be given to the 
question of hygiene, diet, and excretion to meet the 
psycho-physical requirements of the mind and body 
in normal health. As a rule, diet is prescribed for 
the purpose of relieving the various annoying 
and painful symptoms caused by chronic impair- 
ment of the functions of the stomach and bowels, 
but when we find the cause of these various symp- 
toms arising from a disturbed gastro-intestinal tract, 
the question of diet will receive less attention. 
Why has not the subject of normal intestinal 
165 



Intestinal Irrigation 

excretion received as much attention as diet in 
health or ill-health? As our knowledge of the 
human psycho-chemical laboratory increases, we are 
able definitely to locate a diseased organ and 
account for the symptoms caused by the patho- 
logical condition of that organ; and when the 
diagnosis is properly made these symptoms become 
a secondary matter of treatment. 

The chief enemy of health among school children 
(and older persons as well) is the accumulation 
and retention of waste matter and gases in the 
intestinal canal, where are generated ptomaine, 
toxic, and other poisons which enter into the system, 
resulting in self-poisoning or auto-intoxication. 

What do we mean by school hygiene ? Is it 
only the school building, or the external appearance 
of the children, their eyes, teeth, mouth, nose, 
hands ? What about the coated tongue, foul 
breath, fouler stomach, and putrefaction of the con- 
tents of their intestines ? A human being is only 
an extension of his gastro-intestinal apparatus, 
hence it is very essential that such apparatus should 
be in a hygienic state to ensure his physical and 
mental resistance and efficiency being at their 
normal strength. There is one symptom that 
causes more sickness and suffering from infancy to 
old age than all others combined — that is, constipa- 
tion with its attending putrefaction and foulness of 
digestive organs. Only a small percentage of 
people escape its baneful effects or the secondary 
diseases induced by fecal and mucus auto-intoxi- 

166 



The Health of School Children 

cation. Such a common primary symptom must 
have, necessarily, a common exciting cause or 
origin. Through many years of clinical experience 
as a gastro-enterologist and proctologist, we have 
found that inflammation of the anus, rectum, and 
sigmoid flexure is the frequent or common cause 
of constipation. Observation has demonstrated 
that a soiled diaper is the exciting cause of Proc- 
titis and Sigmoiditis in the beginning. Examina- 
tion of one hundred children of the "defective 
class " would show most of them suffering from 
chronic Proctitis and Sigmoiditis, with some degree 
of constipation and auto-intoxication, and even 
of those classed as " healthy school children " a 
large percentage would show the same conditions. 
The continuous invasion of the neighboring tissues 
by the disease, the increasing auto-intoxication 
and constipation, the on-coming malnutrition, and 
anemia, the gradual emaciation, are all the while 
lessening the vitality and power of bodily resistance 
of their victims. The early inception of the malady 
and its insidious progress, with the symptoms and 
diseases resulting, easily deceives the victim as well 
as the parents and medical advisers, until the long- 
pent-up virulence breaks forth, showing itself in 
every part of the tabernacle of the spirit of man, 
when the removal of the primary cause does little 
or no good. 

The Department of Health, in examining the 
sanitary or hygienic condition of a school building, 
would not devote all its attention to the top story 
167 



Intestinal Irrigation 

to overcome unhygienic conditions; it would prob- 
ably direct its attention to the trap and vent of the 
sewer of the building to see that there was no 
retention and filling up of the pipe to befoul the 
atmosphere of the structure. Why then so much 
attention to the head or top story of the human 
temple, and so little to the trap and vent of its 
sewer? Are modesty and ignorance to defeat the 
progress of hygienic measures dealing with the 
stomach and bowels of our school children? How 
long will those abdominal incubators of poisonous 
microbes and gases be allowed to infect not only 
a school building but all its occupants as well ? 

The absorption into the system of serous, fibrin- 
ous or albuminous mucus exudations from the 
invasion of chronic inflammation through all the 
layers of the tissues of the anus (Figure i), rectum, 
and sigmoid flexure, as well as through the adjoin- 
ing fatty tissue in the pelvic space around the 
organs (Figure 5), under the skin and between the 
muscles of the buttocks, goes on continuously, cre- 
ating an extensive inflammable area and source of 
exudation of broken-down tissues. (See Chapter 
III.) It is a grave pathological condition and the 
source of mucus auto-intoxication, and its symp- 
toms ought to be differentiated from those of fecal 
auto-intoxication. This mucus exudate has an 
intensely irritating effect on the nervous system, 
especially when an acute intestinal mucus storm 
has developed, torturing its victims and unfitting 
them mentally to attend to the ordinary duties of 

168 



The Health of School Children 

the day. Very often this is accompanied by more 
or less pain or muscular soreness. These annoy- 
ing symptoms occur very early in the history of 
Proctitis and Sigmoiditis, and clinical experience 
has demonstrated to me and to my students the 
necessity for infants and children being examined 
in order to determine whether inflammation exists in 
the anus and rectum, and thus early cut short the 
progress of the disease and its numerous and fa- 
miliar symptoms, which I may here enumerate, to 
wit : indigestion, flatulency, coated tongue, foul 
breath, bad taste in the mouth, capricious appetite, 
nausea, intestinal colic, cramps and pains, diarrhea, 
headache or band of pain encircling the head with 
sense of constriction, neuralgia, pain about the 
heart, cold hands and feet, malnutrition, anemia, 
emaciation, dry skin, seborrhea sicca, carbonic acid 
toxemia, sallow complexion, liver spots, jaundice, 
acute bilious attacks, drowsy states, mental torpor, 
bad temper, night terrors, irritability, melancholia, 
vertigo, dizziness, loss of memory, insomnia, drawn 
face, tired feeling, unrestful sleep, easily fatigued, 
subject to colds, catarrhal affections of the ears, 
eyes, nose, throat, etc., decay of teeth, dry cough, 
loss of hair, impaired vision, sterility, impotency, 
mucus and membranous cords and casts from the 
bowels, sediment in the urine, irritability of the 
bladder, premature age, reduced physical and men- 
tal efficiency, inability to concentrate the mind, 
morbidity, suicidal notions with a view to ending 
mental and physical suffering. 
169 



Intestinal Irrigation 

I am pleased to inform such sufferers that their 
ills can be properly diagnosed and treated; and the 
earlier in life they seek treatment, the sooner they 
will escape the accumulative ills that make exist- 
ence so painful to endure. 

We have mentioned Proctitis and Sigmoiditis as 
the primary cause of intestinal stasis in the majority 
of cases; later, other sections of the intestinal 
canal may be invaded by inflammatory process, 
causing a more serious intestinal stasis, not infre- 
quently bringing about dislocation of the stomach, 
intestines, and other abdominal organs. We have 
enumerated the symptoms and maladies that are 
now, in the light of latest medical science, traceable 
directly or indirectly, to this primary cause; in short, 
it may be said that, with the exception of a few 
diseases caused by toxic agents, most of the ill- 
nesses that cause so much invalidism, cutting short 
our lives, can be traced to mucus and fecal auto- 
intoxication. 

The purpose of this book and others I have 
published is to educate my fellow beings as to how 
to prevent or avoid the many diseases and symp- 
toms that afflict them from the cradle to the grave; 
already I feel that I have accomplished something 
in helping humanity, and I trust others will do their 
part to lessen the ills that flesh is heir to through 
neglect and ignorance. 



170 



CHAPTER XXI. 1 

Internal Hemorrhoids or Piles versus Rectal 
Mucous Sac, Recto-Anal Mucous Sac. 

DEFORE the history of medicine and surgery 
U began, man suffered at his hinder parts as well 
#s at other parts of his organism. Bodily ills are 
as old as the human race, and the flowing of blood 
from the "terhinder" was a signal of distress or 
of physical anarchy, of which the references to 
"emeroids" in the Bible and in other ancient writ- 
ings bear witness. The "emeroid" doctors of 
Egypt, in the time of Moses, unquestionably re- 
garded the distress caused by the " emeroids " as a 
disease. And it came to pass that every subsequent 
Moses that has written on the subject of hemor- 
rhoids up to the present time has regarded piles as 
a disease. And they likewise, all of them without 
exception, believe the " disease " to be hereditary, 
as is certainly their information on the subject. 
This mental obsequiousness of the proctologists of 
our day is indeed quite a long-drawn-out compliment 
to the pile doctors of Egypt, since our proctologists 
still continue to diagnose piles as a disease and " to 
smite the smitten of emeroids." 

» Chapters XXII, XXIII, and XXIV have been revised from Papers 
contributed to Albright's Office Practitioner, in iyo$, 

*7* 



Intestinal Irrigation 

I have always respected the idea of ancestral 
worship and of reverence for the dead past, but at 
the same time I have felt that one should not be 
wholly oblivious to their egregious mistakes. 

If Moses, Samuel, Herodotus, Hippocrates, Galen, 
and other illustrious men had said that " emeroids " 
is a symptom of a disease, what a blessing they 
would have conferred upon suffering humanity. 
The simple use of that one word would have been 
illuminating, and would have set the tide of atten- 
tion for the proper diagnosis and treatment in the 
right direction. Possibly some one more bold than 
the servile brotherhood did see and say that it was 
a mere symptom, but, if so, his temerity was treated 
by " the wise ones " of that day as similar innovations 
are treated to-day, with a " Tut, tut tut ; pugh, pugh, 
pugh. We know better, and we refer you to the 
following chapters in Holy Writ and to the classical 
work of the great Medi Cusus on ' Pilus Diseasicus.' 
And besides, have you no respect for the superior 
clinical advantages we enjoy ?" 

Notwithstanding the bad odor in which I shall be 
held, I will nerve myself to claim that, when the 
ancients considered and called piles or hemorrhoids 
a disease, they made a very grave and palpable 
mistake, and that, having made this mistake, it was 
inevitable that numerous errors should follow logi- 
cally in its train when they attempted to account for 
the etiology, character, and means of cure of this 
" disease." 

Pruritus ani is also called a disease, and a similar 

172 



Internal Hemorrhoids or Piles 

bedlam of reasons is offered as causes and means 
of cure, all of which accounts for the many, many 
pages of a book filled to overflowing by a " classical " 
author, with compilations of the redeeming gospel 
truths on this subject from prehistoric times till the 
present day, including his own commentary, guesses, 
interpretations, and surmises. Ignorant as he is of 
the nature of this symptom, the conjectures of his 
perfervid imagination are "to laugh." The errors 
of one or more authors, endorsed by the mistakes 
of others, seemingly make a truth to minds that 
are vassals to authority, which accounts for much 
of the useless medical literature of to-day and for 
the mistakes of those that are misguided by it. 

Considering the pathological condition, it would 
be better if we were to give a more definitive char- 
acterization to it than "piles" or " hemorrhoids." 
In accordance with the distinctive exhibit con- 
templated, we should describe it as a rectal mucous 
sac, an ano-rectal mucous sac, or an ano-muco-cu- 
taneous sac. These are more distinctive and suit- 
able designations for these symptoms of chronic 
proctitis, inasmuch, by such designations, we call 
attention to the fact that they are simply constricted 
mucus T channels and sacs, with engorged arteries 
and veins, formed by the serous exudation that ac- 
companies inflammation. 

If a recto-anal mucus channel, under one or more 

1 1 found it more convenient to use the words mucus channel^jnucus 
fistula, etc., in preference to sinus, as they better convey my ideas to the 
average reader. 

173 



Intestinal Irrigation 

layers of the mucous membrane, becomes constricted 
or obstructed (they usually do), its epithelial wall 
will become sacculated, and then we have a rectal 
mucous sac, or an ano-rectal mucous sac, or an ano- 
muco-cutaneous sac, all of which may be present in 
the same case. The inflammatory exudation called 
serum distends and destroys fatty tissue, which 
makes space for its lodgment under the tissue that 
imprisons it, and at the same time there occurs 
more or less proliferation of the cells of the tissue 
involved in the severe inflammation. The internal 
sphincter muscle, by its contraction, aids in the 
undue retention of the mucus and blood above it, 
hence the so-called pile-bearing region — that is, the 
sacculated mucosa region. The serous exudation 
meets with obstruction along the anal canal and the 
mucosa is sacculated. When the integument around 
the anus offers obstruction to the flow of serum and 
blood, we find that muco-cutaneous sacs are formed 
around the anus. If the exudation occurs in the 
areolar space under the ano-rectal mucosa, it 
readily passes down into the areolar space under 
the integument around the anus, and thence to 
parts deep, devious, and far away, as described in 
Chapter III. 

Channels, reservoirs, sacs, that would hold from 
one to eight or more ounces of fluid, no longer 
excite my wonder and amazement at the extensive 
and serious pathological condition of which they 
are exhibits, a pathological condition that occasions 
symptoms often diagnosed as sciatica, rheumatism, 

174 



Internal Hemorrhoids or Piles 

myalgia, caries of the coccyx, coxitis, prostatitis, 
pruritus ani, scroti, and vulvae, auto-intoxication, 
anemia, invalidism, etc. 

Inasmuch as we have learned the cause of sac- 
culated mucosa at the lower end of the rectum and 
over the anal canal and of the integument around 
it, we had better in future omit the following desig- 
nations and distinctions, which are merely a ridicu- 
lous display of sciolism. Surely we can do with- 
out them, and ought to do so for the sake of 
truth and simplicity. With a sigh of relief let us 
in future ignore : Safety-valve piles, organized 
piles, itching piles, blind piles, bleeding piles, 
moon piles, cutaneous piles, thrombotic piles, ex- 
ternal and internal pile tumors, venous piles, 
ulcerated piles, capillary piles, mixed hemorrhoids, 
arterial hemorrhoids, white hemorrhoids, acute 
hemorrhoids, chestnut hemorrhoids, chronic hemor- 
rhoids, inflammatory hemorrhoids, hypertrophic 
hemorrhoids, atrophic hemorrhoids, Egyptian piles, 
Philistine itching hemorrhoids, etc. 

Quite naturally such a variety of "diseases" 
called forth many sorts of surgical operations for 
their removal, of which the following are the ones 
most in vogue : Clamp and cautery, ligature, crush- 
ing electrolysis, excision, submucous ligation, the 
Whitehead operation, the Earle operation, the 
American operation, etc. 

Forget them all, forget all of the senseless terms 
that are employed to describe a supposed variety 
of " disease " and all of the barbarous procedures 

175 



Intestinal Irrigation 

for their banishment, and the banishment, alas ! 
too frequently, of the wretched sufferer likewise. 

Study carefully the varieties of chronic inflam- 
mation and the character and extent of the exuda- 
tion in each case. By so doing you will ascertain 
the nature of the many varied symptoms of proctitis, 
of which the following are the most common : 
Sacculated mucosa and integument, submucous and 
subtegumentary channels, reservoirs, pockets, fistula, 
pruritus ani, fissure- or ulcer-in-ano, constipation, 
diarrhea, etc. 

Proctitis may present a chronic, a subacute, or an 
acute stage, with an atrophic or hypertrophic con- 
dition, or a less marked structural change in the 
tissue. If proctitis were treated early in its incep- 
tion, none of the above-mentioned symptoms would 
have occasion to develop. When mankind becomes 
properly enlightened on the subject of proctitis, due 
attention will be given to it long before so many 
annoying symptoms occur. 

Ano-rectal mucous sacs, formed by the serous 
exudation into the connective tissue and stasis of 
the blood, are the slightest symptoms of proctitis, 
and by far the most easily removed. 

Since we have found out what are the symptoms 
and what is the disease, it naturally follows that in 
treating a sacculated mucosa we should be governed 
by the character of the proctitis, whether it be in a 
chronic, subacute, or acute stage. If the inflamma- 
tion be acute, no matter whether or not there is a 
general prolapse of the sacculated tissue, it may be 

i 7 6 



Internal Hemorrhoids or Piles 

well to delay the treatment for removal of one or 
more mucous sacs until we have in a decree c 
come the acute inflammation by the use of a 
i.-.z bath, Fig. 23, and by the use of a soot. 
ointment and liquid remedy, to meet the depurant 
requirements of the case. 

The removal of the chronic inflammation, in what- 
ever state it may be found, should be a paramount 
feature of the treatment from the time a case cc mes 
under one's care. The cure of the d: s e 1 s e : _ r.t to 
be of more importance than the removal of z symi • 
torn or symptoms. Should there be bleeding from a 
mucous sac, or shoal i there be prolapse of it, orbot 
immediate treatment will jive relief at once zr.i'.zt 
5 1 3 trer will think you b ave :- r: Mined a miracle es- 
pecially if the annoyance has existed for many years 

After the immediately annoying nracons 5i:- c are 
removed by the hypodermic method, a physiciai] 
: 1 a doub ly ga a r 1 his reputation in the p ainless 
treatment of mucous sacs by delaying further treat- 
ment of those remaining 51:5 which ii treated, 
might occasion special annoyance, till soch 1 time as 
the general inflammatory condition is much 
proved ; but in the interim he may treat the mucous 
sacs that are located above the sphincter muse 
and the granular and ulcerated regi : n 5 

For the almost universal succe 55 in the painks s 
removal of mucous sacs, the operator should be 
possession of all of his normal whs and senses so 
that his judgment wiD be a: its best when the fol- 
lowing points zrz^zr: themselves 

:-- — :; 



Intestinal Irrigation 

What to treat. 

When to treat it. 

Where to treat it. 

How much to treat of it. 

The quantity of remedy to be injected — all of 
which require discretion and good technique. 

By the hypodermic method of treating mucous 
sacs some escharotic is employed with the object 
of causing the absorption of the sacculated mucosa. 
The object to be accomplished ought to determine 
the proper strength of any escharotic used. What- 
ever will absorb the mucous membrane involved in 
the sac in the slowest and mildest manner is the 
best remedy or the best way to employ any of the 
tissue absorbers you might select. And another 
fact : the lower the per cent, employed the larger 
the quantity that may be used at a time, and this is 
desirable if the area of a sac be large and you wish 
to absorb the greater portion of it. A skillful 
operator will make sure to have the escharotic used 
cover just the amount of the mucous sac desired, 
and no more. Physicians that are not aware of the 
channeled and sacculated character of the mucosa 
in the case of "piles" or "hemorrhoids" are liable 
to introduce the escharotic into the base or the 
center of the mucous sac with the hypodermic 
needle ; and in such an event the remedy often 
enters a cavity or a channel, or both, and naturally 
it finds its way along the channel to the integument 
at the anus, whence, as a consequence, a deep, ugly 
fissure-in-ano is in a short time to be reckoned with 

178 



Internal Hemorrhoids or Piles 

by the patient and the physician, because of the 
destruction of the epithelial wall of the channel. 
The patient thereupon is far from being in a 
good humor, and the physician wonders how the 
thing happened, and he feels like quitting practice 
altogether, and doubtless many have done so ; and 
certainly every one should do so if such an error 
were to occur a second time. 

The object we wish to accomplish is to absorb 
the wall of the sacculated mucosa. Therefore the 
remedy should be injected at the apex of the sac, 
in the epithelial layer, or slightly deeper, if the 
occasion demands it. The area of the sac and the 
thickness of its walls must be taken into consider- 
ation, and will suggest the amount of the escharotic 
to be used. 

A proper speculum is very essential to the suc- 
cessful treatment of sacculated mucosa, and I know 
of none equal to that devised some thirty years 
ago by Dr. A. W. Brinkerhoff. The speculum is 
easy to introduce, and by drawing a slide the tissue 
is properly exposed or shut out to a nicety, ex- 
hibiting just the amount you wish to treat. In 
some cases there is a rather lengthy sacculated mu- 
cosa on the side, or on the anterior wall of the ano- 
rectal tube, and it is advisable to treat only the 
upper third or half, and at a subsequent visit or 
visits to treat the remainder, thus avoiding an- 
noyance to the patient. 

The paramount concern should be to avoid 
causing pain both during the treatment of a sac- 

179 



Intestinal Irrigation 

culated mucosa or its possible occurrence a few 
hours or days later. I have often remarked that 
when pain or soreness follows the treatment of a 
mucous sac the fault is in the application of the 
remedy, and not in the remedy itself. Now and 
then there may be conditions in which you will 
expect pain or soreness to follow the treatment, and 
you will prepare your patient with the necessary 
appliances and remedies to overcome it promptly. 
Where there are no possible means for avoiding 
the pain consequent upon a treatment, leave 
nothing undone to make it as slight as possible. 
All mucous sacs ought to be treated without any 
after-annoyance to the patient, and they can be if 
we only wait for the proper time to treat them. 

I have not thus far considered the muco-cutane- 
ous sacs around the anus, which are neither useful 
nor ornamental, and which often indicate the vol- 
canic action of inflammation and the amount of 
mucous lava thrown out around the vent. 

180 



CHAPTER XXII. 

External and Thrombotic Piles versus Muco- 
cutaneous Sacs and Thrombus. 

'THE vent of a crater indicates the convulsive 
* and destructive changes that have taken place 
within ; and, very often, the vent of the gastro- 
enteric sewer gives like evidence of long, great, and 
severe destructive changes. The fire of inflam- 
mation has burned fiercely for many, many years, 
and serous lava has, from time to time, poured 
forth, leaving a searing, inflammatory path. As it 
was forced from the recto-anal crater, the acrid, 
burning mucus, that had been imprisoned, made 
subcutaneous streams, cavities, channels, sacs, 
etc. Its course is marked around the anus by 
peaks, crags, muco-skinny tabs, small and large 
bulging muco-cutaneous sacs, dilated anal veins in 
which clots of blood often form ; light gray, brittle, 
shiny skin with small and large red and sore oases, 
thickly studded over the itching area, which the 
sufferer has scratched in the vain hope of appeas- 
ing the torture of pruritus ani, scroti, vulvae ; while 
cold drops of perspiration stand over his or her 
face and body, serving to indicate the physical and 
mental anguish inexpressible in words. 

181 



Intestinal Irrigation 

Muco-serous exudations under one or more 
layers of the recto-anal mucous membrane finds its 
way down to the integument around the anus, and 
being of a very irritating character, greatly in- 
creases the inflammatory process in the tissues it 
comes in contact with. Thus the increased in- 
flammation and blood stasis and the augmented 
serum unite in hurrying the development of skinny 
tabs and the more or less capacious muco-cutaneous 
rugae and sacs. 

When the serous exudation takes place entirely 
under the recto-anal mucous membrane, there may 
be formed a large muco-cutaneous anal sac, espe- 
cially on the right or left side of the anus, or the 
serum may pass under the integument about the 
anus with little or no anatomical change in the ap- 
pearance of the skin at or about the anus. In the 
latter case, an experienced eye can detect sufficient 
evidence to diagnose the destructive changes 
wrought by the presence of serum in the connec- 
tive tissue under the skin and ano-rectal mucous 
membrane. 

The skin is not, as it should be, held fast by the 
connective tissue, but lies loose over the cavity ; 
and a similar pathological condition exists under 
the mucous membrane of the anus, rectum, and 
sigmoid flexure, which circumstance might lead one, 
in some instances, to conclude that there was al- 
most an entire separation of the mucous membrane 
from the areolar tissue, by the ridges, folds, large, 
pouched, prolapsed, sacculated regions of mucous 

182 



External and Thrombotic Piles 

membrane that has the appearance of having been 
simply carelessly laid over the muscular structure 
of the organs. When we observe such destructive 
changes by the invasion of serous exudation under 
the mucous membrane, we have every reason to 
expect periproctitis and perisigmoiditis, with the 
possibility of the formation of pus occurring with 
the usual consequences. So remarkable and serious 
are the excursions of the mucous currents into 
healthy neighboring tissue that we find a symptom 
of a disease vastly more annoying and serious than 
the disease itself. Is it any wonder we find steno- 
sis (narrowing of the passage) of eight, ten, or more 
inches of the lower portion of the large intestine, 
which is usually diagnosed atony of the bowels ? 
Surely, you must by this time appreciate the reason 
I made so strong an appeal for the twice daily use 
of the enema as a means of relief. You need the 
combination of many aids over a long period of 
time to effect a cure of proctitis, etc., and its nu- 
merous symptoms. Proctitis and colitis is a serious 
affliction, and should have your undivided attention 
with the hearty co-operation of the patient in ef- 
fecting a cure. How foolish is the practice of re- 
moving one or two annoying symptoms (piles and 
fistula) and leaving the sufferer untreated, the dis- 
ease itself and the other symptoms not so apparent 
at the time of the operation, and then dismiss the 
case as cured ! Shame on such practice, in which 
ignorance and cupidity dominate ! Humanity cries 
for a correct diagnosis and a humane treatment ! 

183 



Intestinal Irrigation 

The profuse serous exudation resulting from 
proctitis and sigmoiditis makes its way from the 
diseased area into the neighboring regions like lava 
from an active volcano, carrying with it an intense 
burning inflammation, destroying normal fatty tis- 
sue as it advances, owing to its extremely acrid 
character. Is it any wonder that we find dilated 
veins and arteries in the lower rectal and ano-rectal 
canal and around the anus where stasis of the blood 
has existed for a great many years ? The real 
wonder is that thrombus in the veins around the 
anus does not occur more frequently than it does. 
What is the necessity of calling such a pathological 
change in the caliber of a vein and the weakening of 
its walls " thrombotic pile " ? Thrombus is a clot of 
blood in a vein, and there is no use in adding the word 
"pile." The aggravated character of the inflam- 
mation accounts for the hypertrophied and the cica- 
tricial tissue so often found around the anal vent of 
proctitis cases. The Biblical suggestion that sac- 
culated mucosa, commonly termed piles or hemor- 
rhoids, is a disease, accounts for the numerous 
names used to designate the particular variety of 
the disease — whether it be an internal or an exter- 
nal pile tumor. It is very wrong to so mislead 
"scientific" medical men. Had they only known 
that the numerous sacs, bags, prolapsed pouches, 
longitudinal and transverse folds of the ano-rectal 
mucous membrane, and the ragged, jagged, pro- 
lapsed, pouched muco-cutaneous tissue around the 
anus, as well as the fissure-in-ano, pruritus ani, fis- 

184 



External and Thrombotic Piles 

tula, are only symptoms of a disease, all of the 
many abnormal changes and the other symptoms 
could have been prevented many generations ago 
by simply treating their exciting cause. But it is 
never too late to learn things that will benefit 
mankind. 

Don't for a moment think that all of the 
structural changes on the mucous membrane and 
about the anus mentioned above indicate an afflic- 
tion only skin deep, or even the depth of the 
mucous membrane. They are far worse than that. 
You will find all the muscular structure of the anal 
organ and that of the rectum sigmoid flexure 
severely invaded by the inflammatory process and 
its fibrinous exudation, and also the external tissues 
that surround and support the organs. 

We have circular and longitudinal muscular tissue 
entering into the structure of the anus and rectum. 
The sphincter muscles are two large and strong 
muscles that close the anal orifice and guard its 
vent very effectually if they are not destroyed by a 
surgeon's knife. 

The acrid burning serum coming in contact with 
the muscular tissue excites an aggravated inflam- 
mation in its structure as elsewhere. The constant 
irritation results in more or less permanent contrac- 
tion of the sphincter muscles in which fibrinous 
exudation takes place, binding the contracted mus- 
cular fibers together. In time their expansibility is 
lost in many cases, and in other cases partially so, 
necessitating divulsion of the sphincters in order to 

185 



Intestinal Irrigation 

break up the adhesions and establish a somewhat 
normal circulation of the blood in the diseased 
parts, also in order to relieve the irritation to the 
nerves distributed to the organs and their marked 
reflex excitement. In some cases an expansion of 
the sphincters for one and a half inches or two 
inches is quite sufficient ; other cases may require 
a little more thorough divulsion ; but never weaken 
or paralyze the sphincters, as your patient needs 
their normal use, and you need the reputation of 
never causing incontinence of feces. Guard the 
usefulness of the sphincters as you would a 
valuable treasure. 

As a rule, I treat all of the ano-rectal sacculated 
mucosa in cases where divulsion is required before 
performing the dilatation to break up the adhesions, 
and very frequently the muco-cutaneous sacs and 
distended veins as well. It may be well to delay 
the divulsion — with which there is usually no hurry 
— until you determine how many U-shaped (or hair- 
pin shaped) mucus channels and recto-anal mucus 
fistulas there may be present that have passed down 
under the recto-anal mucous membrane, down to the 
integument about the anus, and then pressed imme- 
diately upward again along the outer wall of the 
anus and rectum, to the extent of six inches or 
more. There may be three, four, six, or more of 
them quite prominent as to length and size. 

For the treatment of the recto-anal sacculated 
mucosa the injection method is par excellent. For 
the removal of the muco-cutaneous sac a double 

186 



External and Thrombotic Piles 

V-shaped incision, the proper depth, length, and 
width, will remove the surplus or redundant tissue, 
after which the edges are brought together with a 
catgut suture,— or omit the suture if you think best, 
— followed by the home attention as prescribed for 
fissure-in-ano in a previous chapter. At the time 
of removing the sacculated tissue attention may also 
be given to the mucus channel ; or you may, if you 
wish, leave it so that at some future treatment you 
can give it the desired attention. A one or two 
percent, solution of alypin, cocain, or betaeucain 
will produce the necessary local anesthesia for a 
painless operation. I remove only one muco- 
cutaneous sac at a treatment, which permits the 
patient to go about as usual without much incon- 
venience. 

If you have removed all of the ano-rectal saccu- 
lated mucosa in a case, and have omitted to remove 
the one or more ano-muco-cutaneous sacs or dilated 
veins that are so often present around the anus, 
and have also neglected to cure the chronic proc- 
titis, then the sacculated mucosa may, by some 
hook or crook, become excited again into an acute 
inflammatory condition, the sphincter muscles may 
grip tighter than usual, and lo, thrombus has taken 
place in a vein, and the wrinkled, shriveled, skinny 
tab or sac looks like a miniature balloon, and your 
dismissed patient is in a troubled state of mind to 
have everything come back on him so soon! 

The cure was all right so far as it went, but 
there was the disease and some of the old external 
187 



Intestinal Irrigation 

symptoms to tell the tale of an incompleted treat- 
ment. 

Those muco-cutaneous sacs at the enteric crater's 
mouth are just so many thermometers at its vent 
to tell the temperature occasioned by the fire of in- 
flammation within, and they will damage your 
reputation as a proctologist if they be not removed. 
By all means get rid of these symptoms and in- 
dicators of trouble within ; and if there should by 
chance be a little of the old proctitis remaining 
that wants to assert itself by making trouble, 
in becoming acute, it will be surprisingly handi- 
capped in its efforts, and the chances are all in your 
favor; and you will, moreover, from time to time, 
hear what So-and-So said about the very successful 
treatment of his or her case. 

Sacculated mucosa, muco-cutaneous sacs, sub- 
mucous channels, etc., having their source in the 
rectum and anus, are all of a similar origin, the 
result of serous exudation. These symptoms of 
proctitis vary in development and number according 
to the nature and progress of the disease. In those 
cases that are quite exempt from sacculated mucosa 
(piles) you may expect to find submucous channels 
largely developed, and vice versa. 

Too much stress cannot be placed upon the se- 
rious results of auto-intoxication by the absorption 
of mucus from channels and cavities that will 
hold from three to eight or more ounces of fluid at 
one time. They are no doubt rapidly emptied by 
the process of absorption into the system. 

18S 



External and Thrombotic Piles 

I have not referred to the fatalities of the hypo- 
dermic treatment of sacculated mucosa (piles or 
hemorrhoids) because of the fact that none have ever 
occurred within my knowledge among those using 
either this or a similar method of treatment. 
189 



CHAPTER XXIII. 

Abscess and Fistula Involving Anus, Rectum, 
and Neighboring Regions. 

TTIPPOCRATES, the father of medicine, Cel- 
* * sus, Galen, and other writers in the early 
times, described fistula as a disease ; and, naturally 
enough, through the influence of heredity, con- 
tagion, imitation, and auto-suggestion, every author 
on the subject to the present day has chimed in 
most complaisantly with his " Ditto ! ditto ! ditto ! " 
" Me too ! me too ! me too ! " I am sure that the 
rank and file of my medical brethren will agree 
with me that modern authors are hardly justified 
in this servility to the ideas of the fathers of medi- 
cine in this recreance to their duties toward suffer- 
ing humanity. Is it that they do not know better, 
or that they are naturally servile and thus too lazy 
to do their own thinking? 

Let me in connection with this point call your 
attention to a practice that many of us have been 
suspicious of for a long time, a suspicion that has 
been confirmed for me by one who speaks from 
positive knowledge ; otherwise I should not refer 
to it here. The practice I am about to describe 

190 



Abscess and Fistula 

will make it plain why we have so many " Ditto 
and Me-too " authors on proctology and other 
medical subjects. 

An eminent surgeon who mentally is as large as 
the human race, and has room for all that is good 
in medicine and surgery, narrated the following 
incident of his career to a learned doctor from 
Georgia and myself recently. Snatching occasion- 
ally a few moments from a busy practice, he has 
prepared sufficient material to make a book, and 
desired some competent person to edit it before 
publication. So he consulted an ethical co-worker 
concerning such a person. In a few days a gentle- 
man called at the doctor's house to inquire about 
the contemplated publication. The caller asked 
the title and size of the book, and when told volun- 
teered the startling information that he could have 
the work ready in a few weeks' time, but that in 
the meantime he would like to hear the doctor 
lecture once or twice that he might catch a few 
peculiar expressions to use in the work, so that the 
doctor's friends, when reading the book, would say, 
" That sounds just like the doctor ; that is his style 
of talking." The would-be scribe never asked for 
the authors manuscript, so accustomed was he to 
rely upon the medical literature to be found in the 
libraries of the city for all the information needed. 
It is hardly necessary to add that the professional 
bookmaker was summarily dismissed. The doctor's 
manuscript is still unpublished. 

There is a third reason for so many " Ditto and 

19* 



Intestinal Irrigation 

Me-too " authors. Publishers of medical books 
naturally desire to extend their business, and in 
order to do this they must issue new works of medi- 
cine in the same way that lay publishing houses 
compete for new works of fiction. Now, doctors 
usually obtain professorships in some institution by 
paying five thousand dollars or more for them, and 
in due time a publisher of medical books will tempt 
the professor to become an author. They place 
before him their great facilities for getting up a 
book, arguing that consequently but little or no 
labor on the professor's part is required. They 
point out to him the fame and honor the publica- 
tion will bring him, and at the same time estimate 
how much money they will make out of it. In due 
time a " Ditto and Me-too " medical brief, resume, 
or treatise, is published covering the whole history 
of the subject, from Biblical mention of it to the 
present day. All of us have observed what a great 
amount of stuffing or padding it takes to make a 
book that is to sell for five or seven dollars. It 
occurs to me that it might be wise to get up a con- 
ference of enlightened physicians to take some 
practical steps or to devise some laws that will 
prevent such impositions on the too confiding 
medical brethren by unscrupulous publishers that 
rob them of their hard-earned income through de- 
lusive advertising. Still, before any action is taken 
that would result in effectively closing the door to 
this practice, it may be as well that the eyes of 
more of us should be opened that we may not con- 

192 



Abscess and Fistula 

tinue to be duped and stung again and again by 
" Ditto and Me-too " scrapbooks with hundreds 
of pictures. When seeking for new and better 
information to help suffering humanity, let us be 
served for a little while longer with " rehashed rot." 

Pardon this digression. We will now consider, 
at first hand, the subject of fistula. 

As a rule, pus in a fistula is a secondary symp- 
tom of chronic proctitis, except those fistulae that 
occur from traumatic injury to the region of the 
rectum, anus, and buttocks. Early in my practice I 
entertained the idea that the formation of pus oc- 
curred at the point of dissolution of the tissue, and 
that, as the volume of pus increased it made its way 
in the direction of least resistance through it, if the 
abscess had not been opened by an incision. The 
idea was well founded when it was applied to the 
traumatic origin of an abscess and fistula, but not 
when their origin was traced to chronic proctitis. 

It may seem incredible to all who read this that 
a mucus channel or a fistula can be formed for 
ten, twenty, forty, or more years before the forma- 
tion of pus takes place in it ; and that the pus exerts 
no part in producing the diameter or length of the 
fistula, which may have a capacity of six, eight, or 
more ounces of fluid. As soon as the chronic in- 
flammatory process has penetrated one or more 
layers of the mucous membrane, mucus channel or 
fistula-formation must take place. If the sphincter 
muscles be rather weak or lax I would not expect 
sacculation of the rectal mucosa to occur to any 

i93 



Intestinal Irrigation 

extent. In these cases, however, the muco-cutaneous 
channels are usually found quite large and numerous. 
Of course the extent of the ano-rectal symptoms in 
each case depend upon how severe the chronic in- 
flammatory process has been, and is, at the lower 
portion of the enteric canal. Often you will find 
that the seat of the most active chronic inflamma- 
tion is in the middle and upper portion of the 
rectum, involving also the sigmoid colon. In these 
cases the ano-rectal symptoms are not numerous, if 
there be any at all, on the mucous membrane, but 
under it you may expect mucus channels that 
serve as outlets for the inflammatory product. 

In every case of chronic proctitis and sigmoiditis 
submucous and subtegumentary fistulae can be 
found, and my experience in tracing them war- 
rants me in stating that periproctitis and peri- 
sigmoiditis is present also; the latter pathological 
condition being due to the invasion of submucous 
and subtegumentary channels or fistulae around 
the outside of the structure of the anus and rectum, 
extending far up into the neighboring tissues of 
the pelvic space that support the rectum and 
sigmoid flexure. 

The formation of pus in a submucous or sub- 
tegumentary channel that has existed for many 
years does not make it a disease; it is only 
another incidental phase added to an already ex- 
isting symptom of chronic proctitis. 

Mucus fistulae should be diagnosed and treated 
early in their formation, or at least before the 

19-1 



Abscess and Fistula 

tissues involved became so deteriorated as to form 
pus in quantity sufficient to occasion the usual 
period of suffering, fever, loss of rest and sleep 
before the pus is freed from its enclosure. The 
formation of pus in a mucous fistula is only in- 
cidental and marks a stage in the distinctive 
changes that have been going on for many, many 
years in the tissues involved in the inflammatory 
exudation. 

The numerous small and large submucous and 
subtegumentary fistulae found in every case of 
chronic proctitis and sigmoiditis was the most 
grave and far-reaching of the numerous symptoms, 
but for three decades I have fully realized the 
baneful effects from mucus irritation, and the self- 
poisoning by the absorption of large quantities of 
serum and fibrinous septic material from the sur- 
face of the mucous membrane involved, as well as 
that from numerous long, cavernous mucus fistulae : 
a fearful double source of auto-intoxication, for 
which it is useless to prescribe diet, tonics, and 
travel for building up the system and restoring the 
health. 

Besides the numerous general symptoms, arising 
from self-poisoning by fecal and mucus absorption, 
we have more or less marked local symptoms in 
many cases ; and if these be not present, the diag- 
nosis can be made out from the general debility of 
the system and the character of the chronic proc- 
titis and sigmoiditis. 

The local symptoms of mucus fistulae, periproctitis, 

195 



Intestinal Irrigation 

and perisigmoiditis are, each of them, universally 
diagnosed as a disease: Such symptoms as pruritus 
ani, scroti, vulvae, lumbago, sciatica, myalgia, rheu- 
matism, prostatitis, coxitis, disease of the coccyx, 
chafing about the anus and along the thigh and 
scrotum, difficulty in getting up after sitting for a 
while, pain in the back of the neck, lame back, legs 
feel tired, and sometimes pain is very annoying, 
abnormal color of the skin, painful or sore spots at 
times, confinement in bed for many weeks from 
severe continuous pain in and about the rectum, etc. 

Up to the present time proctologists have paid 
little or no attention to proctitis and sigmoiditis, 
which is a grave disease, with a far more serious 
symptom, that of mucus fistulae of great length and 
diameter, extending in all directions in the pelvic 
cavity and tissues of the buttocks, the large area of 
tissue found so full of holes, might be likened to a 
sponge occupying the same space. They are very 
numerous in every case of chronic proctitis and 
sigmoiditis. 

This will explain why an incidental symptom 
like pus in a fistula is commonly called a disease by 
the " Ditto and Me-too" authors, and why it is so 
frequently met with in practice. At some hospitals 
one-half of the cases treated suffer from fistula in 
which pus has formed. Why the per cent, is not 
much greater I am unable to explain, except to 
give credit to the defensive and restorative power 
of the human body. If the periproctitis and peri- 
sigmoiditis, brought on by the mucus fistulse, is 

196 



Abscess and Fistula 

not treated at the same time as the cause, the 
treatment will be of no consequence in effecting a 
cure of the chronic inflammation of the lower 
bowels. Every mucus fistula should be located 
and healed at the time that the disease itself is 
treated; then the work will be well done. Every 
mucus fistula should be diagnosed and treated 
before the breaking down of the tissues reaches the 
pus-forming stage, and thus obviate all suffering, 
annoyance, and possible death. Attention to this 
course will ensure your treatment of the disease, 
and its symptoms, to be taken in time. 

The only hindrance to the successful office treat- 
ment of a fistula in which pus has incidentally 
formed is the fear that you can not cure it, or 
that you will fail, or that at a hospital it 
could be cured quicker, better, and cheaper. 
These ideas are born of heredity, timidity, 
fear-habit, power of auto-suggestion, and too 
much caution on your part. They are all false- 
hoods and should not be heeded for a moment. 
During thirty years of practice in my specialty I 
have sent seven of my fistula patients to a hospital 
for treatment, and four of that number I after- 
wards very much regretted sending, as I could 
have accomplished the cure in a safer and better 
way by the usual office method of cure. In fact 
every fistula, pus or no pus, — I do not care how 
bad it may be, — can be cured by office treatment 
and at the same time aided by the home attentions 
of the patient. There may be periods of a year or 

197 



Intestinal Irrigation 

more when your energies are overtaxed with nu- 
merous patients, and you feel like dividing the labor 
with some fellow-practitioner, and this in a meas- 
ure accounts for those I induced to go, or was 
willing to have go, to the hospital. 

Unless overwork is the excuse, you need never 
send a fistula patient to a hospital for treatment. 
I have everything to say in praise of the ambulant 
treatment of ano-rectal fistula and the mucus chan- 
nels, since my practice thus far has been devoid of 
any unfavorable results, — a fact which should have 
much weight in favor of the ambulant office treat- 
ment of all of the many symptoms of chronic 
proctitis, sigmoiditis, and colitis. 

Mucus fistula is very easily healed in all cases, 
and those cases in which pus has incidently formed 
are likewise not difficult to cure. All you need to 
do is to instill intelligence in a stupid patient, if 
you haven't an intelligent one, and induce him to 
utilize or improvise a few home conveniences for 
cleansing the fistula night and morning between 
office visits. During the treatment of the fistula 
patients will be able to attend to their imperative 
duties. 

To properly explore a fistula and its branches, if 
any, as to whether pyogenesis (pus) has taken place 
or not, it is essential to have the external opening 
through the skin of sufficient depth and size to 
permit of the application of remedies over all its 
surface. For a mucus fistula antiseptic remedies 
can be applied after a thorough irrigation by hot 

198 



Abscess and Fistula 

water at a temperature of one hundred and twenty 
degrees, or more, for half an hour or less time, as 
the case may demand. Where pyogenesis (pus) has 
occurred in a mucus fistula there may be more or 
less necrotic tissue formed, which will require the 
use of an escharotic remedy as well as very hot 
water irrigation, followed by an antiseptic remedy, 
if not already incorporated in the hot water used. 

As a rule I see a fistula case once or twice a 
week, as the case may require. There is no pack- 
ing of the fistula after the morning and evening 
home treatment — I have never found it essential. 
A T-bandage is worn, with absorbent cotton, over 
the opening of the fistula, preventing soiling of the 
clothes while attending to daily duties. 

Never mind what the " Ditto and Me-too " proc- 
tologists have copied or rehashed about the cur- 
ing of a fistula, which they persist in calling a 
disease. Just be resourceful, safe, and sane in all 
you do, and every fistula will get well long before 
you have cured the chronic proctitis and sigmoid- 
itis, of which the fistula, as a rule, is a symptom. 



199 



CHAPTER XXIV. 

Nine Radiograph Illustrations of Mucus 
Channels and Cavities. 

JAM indebted to Dr. Caldwell, of New York, 
* at whose laboratory my patients were radio- 
graphed for the very excellent illustrations ; and also 
to Dr. Albright of Philadelphia, for his assistance 
in the radiograph work, while attending my clinic, 
and who, later, with rare skill and scholarly ability, 
presented my discoveries in a large volume, entitled; 
A Practical Treatise on Rectal Diseases, Their Di- 
agnosis and Treatment. 

The following illustrations can only give a hint of 
the pathological conditions that existed. Fig. i 
shows seven, and Fig. 2, eight probes inserted, 
which by no means indicate the number of channels 
or size of the cavities ; twenty-five to fifty or more 
probes inserted would more accurately indicate the 
excursions of the inflammatory exudate. 

The seven following illustrations, in which Bis- 
muth Paste was injected, did not meet my expecta- 
tions in showing the pathological conditions that 
existed. The disappointment was largely due to a 
desire not to cause annoyance to my patients, who 




Fig. i, 



Radiograph showing tube (i) in the rectum; 2, probe inserted S% inches; 
probes 2 and 4 pass on left side of rectum ; 3 and 5 pass on the right ; all pass 
into perirectal spaces; three probes are seen under the integument. 




Fig. 2. 



Radiograph showing tube (i) in the rectum; probes 2, 4, 6, passed on the 
left and front of the rectum; 3 passed forward; 5 under the integument along the 
spine; 7, S, and 9 probes passed to scrotum and thigh. 




Fig. 



3- 



Radiograph showing a large region more or less rilled with bismuth from the 
anal canal forward and upward, as indicated by lines I and 2; a severe case ol 
proctitis, sigmoiditis, periproctitis, and perisigmoiditis. 




Fig. 4. 



Radiograph showing a tube in the rectum and probe passed to the left of the 
rectum into the space where bismuth was injected; a case of acute proctitis, sig- 
moiditis, periproctitis, and perisigmoiditis at time of treatment. 



Fig. 5. 



Radiograph showing bismuth in a perirectal channel on the left side of the anus 
and rectum, which caused continuous annoying pain for many months. 




Fig. 6. 



Radiograph showing a long muco-cutaneous sac and perirectal channel into 
which bismuth was injected; a case of proctitis and periproctitis, etc. 




Fk 



Radiograph showing a tube in the rectum, a long probe and bismuth in peri- 
rectal space, also a probe in a submucous channel ; a case of sigmoiditis, proctitis, 
periproctitis, and perisigmoiditis. 




Fig. 8. 

Radiograph showing bismuth injected in the perirectal space ; a case of proctitis, 
sigmoiditis, periproctitis, and perisigmoiditis with severe constipation and 
indigestion. 




Fig. 9. 

Radiograph showing tube in the rectum, a probe and bismuth in perirectal 
space, and also a probe in a submucous channel ; a case of proctitis, sigmoiditis, 
periproctitis, and perisigmoiditis. 



Nine Radiograph Illustrations 

so kindly consented, in the interest of science, to be- 
ing radiographed. In all cases the paste extended 
over a much greater area than a casual glance at 
the illustrations would indicate. The probes and 
paste were not inserted with the idea of making 
a diagnosis, but simply to suggest research on 
the subject by proctologists. All the cases radio- 
graphed suffered from proctitis, sigmoiditis, peri- 
proctitis, and perisigmoiditis. 



CHAPTER XXV. 

Chronic Mucous Proctitis and Sigmoiditis — 
Usually Diagnosed as Chronic Mucous 
Colitis. 

CHRONIC mucous colitis ought to mean in- 
flammation of the ascending, transverse, or 
descending colon. The length of the rectum varies 
from five to eight inches, and the average length 
of the sigmoid flexure is about nineteen inches ; 
the length of the two organs is thirty or more 
inches. Chronic follicular, ulcerative proctitis and 
sigmoiditis, extending half, or even the whole length 
of the sigmoid flexure, causes great suffering, and 
the symptoms are similar to those attributed to 
chronic mucous colitis. For about thirty years I 
have positively known that many of my patients 
suffered not only from chronic mucous proctitis, 
but from sigmoiditis as well, since I was able to 
make positive diagnosis of the diseased condition 
for at least ten to fifteen inches up the lower bowels. 
If the anal canal is inflamed from any cause and 
not cured, the chronic inflammation will gradually 
extend up the whole length of the rectum and into 
the tissues of the sigmoid flexure, invading the 

202 



Chronic Mucous Proctitis and Sigmoiditis 

organ to a greater part of its length, if not all of it. 
The sigmoid flexure is the normal receptacle for 
feces, and gases, and physiologically and hygienic- 
ally ought to be emptied three times in twenty-four 
hours to keep it clean for those who are in the 
habit of eating food three times a day. The hygienic 
condition of the sigmoid receptacle is entirely de- 
pendent upon a healthy condition of the rectum and 
a sensible tenant of the body; but when chronic 
proctitis has taken possession of the rectum and 
neighboring tissues, it serves no longer as a normal 
passageway for emptying the sigmoid flexure of 
accumulated feces, gases, and liquids. 

At first inflammation causes spasmodic muscular 
contraction of the anus and rectum, which in time 
becomes more and more permanent stricture as the 
progress of disease advances, lessening the bore of 
the organs until it becomes very difficult for any- 
thing to pass into and through the rectal and anal 
canals. Inflammation extending from the rectum 
into the sigmoid flexure for perhaps its whole length, 
interrupts its functions likewise, thus creating an- 
other cause for undue accumulation of feces and 
gases in the organ ; this accumulation of the waste 
material of the body becomes very foul, generating 
toxic gases, putrid substances, and poisonous germs 
which in turn irritate and excite the diseased organ 
from their constant contact with the follicular ulcer- 
ated mucous membrane of the sigmoid receptacle. 
Why should we not find in these cases all the 
symptoms attributed by authors to chronic mucous 
203 



Intestinal Irrigation 

colitis ? Especially so when we have, in addition 
to the enumerated symptoms of colitis, those caused 
by periproctitis and perisigmoiditis, which are always 
present and quite severe. 

As a rule, the symptoms which have been diag- 
nosed as those of chronic mucous colitis, mem- 
branous colitis, or ulcerative colitis are nothing 
more than symptoms of chronic mucous proctitis 
and sigmoiditis, accompanied by periproctitis and 
perisigmoiditis. Proctologists who have written on 
the subject of mucous colitis have noted the many 
symptoms very accurately, but have missed the 
usual location of a most aggravating disease from 
which mankind suffers early and late in life. Authors 
of books on stomach and intestinal troubles are 
also groping very much in the dark and are unable 
to diagnose the cause of a very common functional 
disturbance of the whole digestive apparatus, caused 
by proctitis and sigmoiditis, bringing numerous and 
severe primary and secondary symptoms to which 
other diseases may be traced. 

Chronic proctitis and sigmoiditis and their local 
symptoms convert the sigmoid receptacle into an 
Augean stable, from which foul poisonous gases 
and germs are forced up and along the bowels, dis- 
tending the descending and transverse colon and 
finally reaching the ascending colon and the caecum, 
causing undue retention of their contents ; hence 
so much attention to the caecum and the vermiform 
appendix. The ends of a long rubber tube dis- 
tended with gas will exhibit more strain and dis- 

204 



Chronic Mucous Proctitis and Sigmoiditis 

turbance than the intermediate parts, and the same 
is true of the colon, owing to the intermediate 
sections of the organ possessing greater mobility. 
The great volume of gases confined in the colon 
prevents its normal peristaltic action, causing undue 
retention of contents, with resulting inflammation 
of the caecum, as well as dislocation of the stomach, 
colon, etc., and suggesting radiographic and flouro- 
scopic examination and surgical operations to dis- 
cover the cause of all the trouble, which should have 
been learned through use of the speculum before 
so many complications occurred. 

In all cases of chronic mucous proctitis and sig- 
moiditis where there is a great amount of secretion 
of mucus, membranous cords, shreds, and casts 
(called mucous colitis), I have found the marked 
acute symptoms more or less periodic and accom- 
panied by increased inflammation in all the tissues 
involved in the disease, which convinced me that 
the colitis we read about had become dislocated 
and was where I could see its results without the 
use of a speculum. 

Through often witnessing the phenomena, I have 
learned what a " mucous colitis " storm means from a 
pathological exhibit, a personal demonstration, and 
a verbal description of what the sufferer is enduring. 
It requires the stuff heroes are made of to endure 
chronic mucous proctitis and sigmoiditis for ten, 
thirty, or forty years without the disease being 
accurately diagnosed, and to be told that all treat- 
ment is useless and that the trouble is in the head 
205 



Intestinal Irrigation 

of the sufferer, that he is a hypochondriac, and a 
neurasthenic, terms often used by doctors who are 
unable to make a proper diagnosis of a case. 

The common symptoms of mucous colitis have 
been accepted by writers on the subject, but as to 
the real cause of them there has been thus far only 
mere conjecture, just as the writers have been 
doing as to the cause of pruritus ani, scroti, and 
vulvae. Dr. George M. Niles, of Atlanta, Ga., says : 
" In looking up the literature, one is amazed at the 
divergent views as to the etiology and management 
held by diligent students and competent observers. 
It is fairly well agreed that most cases occur in 
nervous, neurasthenic, hypochondriac, or hysteric 
individuals." Others blame the liver, hysteria, con- 
stipation, fermentative processes in the intestines. 
How foolish to name symptoms of the disease as a 
probable cause of it ! It is not necessary for me 
to again enumerate the many primary and secondary 
symptoms of proctitis and sigmoiditis, but I will 
mention briefly a few nervous symptoms which I 
think are due to the absorption of mucus into the 
system. There is that intense, exasperating, sore, 
and restless feeling, with inability to concentrate 
the mind, with the nerves and muscles of the body 
pinched and contracted. Such feelings are at their 
height during an acute mucus storm, which is an 
indication of increased inflammation in all the in- 
flamed tissues, causing secretion of a great quan- 
tity of mucus or membranous casts. No doubt 
much of the inflammatory exudate from the mucous 

206 



Chronic Mucous Proctitis and Sigmoiditis 

membrane, from the muscular structure of the 
organs, and the connective tissue surrounding and 
supporting the organs, passes into the sigmoidal and 
rectal canals, while a portion is absorbed into the 
system. In a similar manner, the inflammatory 
exudate from a subtegumentary mucus channel and 
cavity passes through the skin, causing moisture of 
the skin, pruritus ani, scroti, and vulvae. I know 
of no non-malignant disease, where the symptoms 
may truly be said to be a thousand times worse 
than the disease that caused them, except in chronic 
proctitis and sigmoiditis. 

Treatment of such cases has been very successful in 
my practice, requiring four principal aids: (i) Local 
treatment; (2) medicated enemata ; (3) local medi- 
cation ; (4) the recurrent application of medicated 
hot water at a temperature of 125 to 135 or more 
degrees. A further valuable aid is the determination 
of the sufferer to get well by faithfully carrying out 
the home treatment. The more a patient studies 
my diagnosis and treatment of his case, the more 
he is encouraged that eventually a cure will be 
effected. Dr. James Moran of this city has been a 
student and assistant at my office for more than 
three years, and will bear testimony to the success 
of my treatment in all cases observed by him. 



207 



CHAPTER XXVI. 

Antiseptic Employment of Powders and Oils. 
depurant powder. 

WATER at a temperature of from 120 to 135 or 
more degrees is an excellent antiseptic if prop- 
erly applied to diseased tissue. Its anti-toxic, sooth- 
ing, and healing properties, however, can be vastly 
increased by the addition of Depurant remedies. 
Water of this temperature, if used in the treatment 
of proctitis or colitis, should be applied with the aid 
of an Intestinal Recurrent Douche. 

Water at a temperature of from 90 to 105 de- 
grees — which is recommended for taking an enema 
— is antiseptic or depuratory only to the extent to 
which it washes away morbid matter from the intes- 
tinal canal. To increase its antiseptic and thera- 
peutic value, as well as to meet other requirements, 
Depurant remedies are administered with the water 
during the flushing of the large intestine. 

The Depurant Powder, prepared by the author, 
readily dissolves in the warm water and is brought 
into contact with every part of the mucous mem- 
brane as far as the antiseptic flushing extends 
along the intestine, thus leaving the washed and 

208 



Employment of Powders and Oils 

sterilized canal sweet and clean — a fit and proper 
channel and receptacle for the on-coming fecal mass. 
Here it may remain about four hours without dan- 
ger of putrefaction, whereas, were the passage-way 
and receptacle foul, the feces would putrefy and 
form gases and toxic material in briefer time. 

This Depurant remedy is not restricted to intes- 
tinal uses ; it is equally efficacious when applied to 
the mucous membrane of any part of the body or 
to the skin. It may be used effectively for washing 
out the bladder or the vagina ; for syringing the 
ear ; for a mouth wash, tooth wash, gargle, nasal 
douching or spray ; for a throat spray ; for bathing 
infants ; and for internal use where foulness of the 
stomach and small intestines exists. It is also a 
valuable adjuvant in the use of water for cleansing, 
or for hygienic purposes, on all the tissues of the 
body. 

DEPURANT OIL. 

Next to the use of water on the mucous mem- 
brane and skin as a hygienic and therapeutic agent, 
I am partial to some of our delightful oils, which 
are bland, non-irritating, and of a pleasing, nour- 
ishing, refreshing effect and exquisite odor. 

To the oil selected as the base ingredient may 
be added other oils, and finally attenuated powdered 
substances of therapeutic value in soothing, purify- 
ing, healing, or any other purpose the case may call 
for. Pure olive oil is an excellent substance in which 
to incorporate Depurant remedies, especially when 
209 



Intestinal Irrigation 

designed to be taken internally, by way of the 
mouth, or applied to the integument of the body. 
Certain other oils are equally pleasing though 
rather expensive. However, an inexpensive oil 
usually serves as a base in which to embody the 
proper medicinal remedies for Depurant purposes 
in the treatment of proctitis and colitis. 

By a proper instrument the oil is carried into the 
intestines with the water used in flushing- the colon, 
or that used with the intestinal recurrent douche 
treatment. The oil, being lighter than the water, 
is carried ahead or on top as the water passes up the 
bowels ; and, as the two liquids open the crevices 
and folds of the mucous membrane or canal, every 
part of the latter is completely covered with the 
medicated oil, as with a covering of thin salve, oint- 
ment, or a poultice — in every nook and corner, just 
where it is most needed and where it should remain 
for its hygienic and healing effect. 

Every kindly aid should be given a diseased 
organ, mucous membrane, or the skin, even if one 
knows it is for relief only ; for the very aids that 
give relief are often essential when joined with 
medicinal or other treatment in effecting a cure. 

It is advantageous in treating bowel troubles to 
use a rather heavy, tenacious oil for a base — one 
that may not be so pleasant to swallow or to use 
externally as some of the lighter oils. It is there- 
fore advisable to have two kinds of Depurant Oil : 
one for internal use (by the mouth) and for the skin, 
the other for chronic disease of the lower bowel. 

210 



INTESTINAL ILLS. 



By Alcinous B. Jamison, M.D., 

SPECIALIST IN RECTAL, ANAL, AND BOWEL DISEASES, AND 
AUTHOR OF "HOW TO BECOME STRONG." 

Cloth, 277 pages 

TPhe above is the title of a work for non-professional 
readers on the cause and cure of many forms of 
bowel and stomach trouble, and their consequences, 
and the scientific treatment of piles, fistula, pruritus 
ani (itching), etc. 

Science is here reduced to common sense ; and 
the intelligent layman, following the directions of 
this book, especially as to " physiological irrigation," 
will be able to prevent the usual daily foul state of 
the stomach and bowels. Here is set forth in plain 
language the accumulated experience of a thoughtful 
physician, who for over thirty years has studied the 
welfare of his patients in the treatment of those 
diseases which are peculiar to civilization. During 
this long practise, patients from all parts of the 
United States and other countries have come to New 
York City to be under the humane and skilful care 
of Dr. Jamison, who has the unique reputation of 
never employing the barbarous surgical and hospital 
methods in vogue throughout the world. No knife, 
ligature, clamp, or cautery has ever been employed 
by him in the treatment of even the most aggravated 
case of piles, or hemorrhoids ; and no detention from 
business is necessary under his treatment for this 
symptom of proctitis. 



Dr. Jamison's discoveries in the line of his specialty 
have added much to medical knowledge concerning 
the etiology and pathology of proctitis, sigmoid- 
itis, and of their symptoms — hemorrhoids, pruritus 
ani, constipation, etc. His diagnosis of these afflic- 
tions is original, as well as his treatment of such 
ailments — hitherto neglected or improperly cared for. 
Physicians and surgeons of conventional schools 
of medicine are not aware that the common cause, 
and indeed the key, of all forms of anal, rectal, and 
bowel trouble is proctitis (inflammation of the lower 
bowel and sometimes of the colon) ; that proctitis is 
the cause of nearly all cases of constipation, diarrhea, 
indigestion, and biliousness ; and that, finally, proc- 
titis is the cause of auto-infection (self-poisoning) 
and its outcome — anemia, emaciation, etc. 

No book to which physicians have access treats 
this subject so fully as ' ' Intestinal Ills, " and yet in 
this volume it is presented in a popular manner suited 
to the common understanding. 

The following enumeration of the chapter head- 
ings will give an idea of the scope of the treatise : 

i. Man, Composed Almost Wholly of Water, is Con- 
stipated. Why ? 

2. The Physics of Digestion and Egestion. 

3. The Interdependence of the Anus, Rectum, 

Sigmoid Flexure, and Colon. 

4. Indigestion, Intestinal Gas, and Other Matters. 

5. Key to Auto-infection. 

6. How Auto-infection Affects the Gastric Diges- 

tion, and Vice Versa. 

7. How Auto-infection Affects Intestinal Digestion, 

and Vice Versa. 

8. The Cause of Constipation and How We Igno- 

rantly Treat It. 



9. Cures for Constipation ' ' Fearfully and Wonder- 
fully Made." 

10. Biliousness and Bilious Attacks. 

ii. King Liver and Bile -bouncers. 

12. Semi-constipation and Its Dangers. 

13. The Etiology of the Most Common Form of 

Diarrhea, i. e. , Excessive Intestinal Peristalsis. 

14. Ballooning of the Rectum. 

15. Ballooning of the Rectum (Continued). 

16. Erroneous Diagnoses and Treatment of Bowel 

Troubles. 

17. Costiveness. 

18. Inflammation. 

19. Proctitis and Piles. 

20. Pruritus, or Itching of the Anus. 

21. Abscess and Fistula. 

22. The Origin and Use of the Enema. 

23. How Often Should an Enema be Taken ? 

24. Physiological Irrigation. 

25. Proper Treatment for Diseases of the Anus and 

Rectum Very Essential. 

26. The Body's Book-keeping. 

27. Selection and Preparation of Food. 

28. Diet for Indigestion. 

29. Diet for Constipation. 

30. Costiveness, Diet, etc. 

31. Diet for Diarrhea. 

32. A Final Word. 

You need this book for yourself and your friends. 
By making a present of it to some one requiring its 
light you will perform an act of unselfish kindness. 

Price, cloth bound, lettered in gold, $2.00, post- 
paid to any address. In sending for the book please 
write name and address plainly. All orders should 
be sent to the author : 

A. B. JAMISON, M.D., 

43 WEST 45th STREET, NEW YORK CITY. 



